Provider Demographics
NPI:1265162432
Name:GEORGIA PAIN & PSYCHIATRY SPECIALIST LLC
Entity type:Organization
Organization Name:GEORGIA PAIN & PSYCHIATRY SPECIALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVEED
Authorized Official - Middle Name:SHAZ
Authorized Official - Last Name:UMMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-212-9520
Mailing Address - Street 1:10475 MEDLOCK BRIDGE RD STE 420
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4439
Mailing Address - Country:US
Mailing Address - Phone:770-212-9520
Mailing Address - Fax:
Practice Address - Street 1:10475 MEDLOCK BRIDGE RD STE 420
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-4439
Practice Address - Country:US
Practice Address - Phone:770-212-9520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-12
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty