Provider Demographics
NPI:1245877489
Name:SERENITY SPINE CENTER
Entity type:Organization
Organization Name:SERENITY SPINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHIRAG
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-201-1540
Mailing Address - Street 1:41 PARK OF COMMERCE WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-1369
Mailing Address - Country:US
Mailing Address - Phone:912-201-1540
Mailing Address - Fax:912-349-2609
Practice Address - Street 1:41 PARK OF COMMERCE WAY STE 200
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1369
Practice Address - Country:US
Practice Address - Phone:912-201-1540
Practice Address - Fax:912-349-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty