Provider Demographics
NPI:1831710854
Name:MD PAIN CARE, P.C.
Entity type:Organization
Organization Name:MD PAIN CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-760-9360
Mailing Address - Street 1:1301 SIGMAN RD NE STE 100
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3819
Mailing Address - Country:US
Mailing Address - Phone:770-760-9360
Mailing Address - Fax:770-760-9303
Practice Address - Street 1:333 ALCOVY ST STE 3
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-2180
Practice Address - Country:US
Practice Address - Phone:770-760-9360
Practice Address - Fax:770-760-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty