Provider Demographics
NPI:1972877074
Name:ADVANCED PAIN CARE, PC
Entity Type:Organization
Organization Name:ADVANCED PAIN CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-226-7585
Mailing Address - Street 1:PO BOX 2205
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30722-2205
Mailing Address - Country:US
Mailing Address - Phone:706-226-7585
Mailing Address - Fax:706-226-9985
Practice Address - Street 1:1107 BROADRICK DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2592
Practice Address - Country:US
Practice Address - Phone:706-226-7585
Practice Address - Fax:706-226-9985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA05BDHJTMedicare UPIN