Provider Demographics
NPI:1447963608
Name:THE INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER PC
Entity type:Organization
Organization Name:THE INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-920-4950
Mailing Address - Street 1:3390 PEACHTREE RD NE STE 1500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-2822
Mailing Address - Country:US
Mailing Address - Phone:404-920-4950
Mailing Address - Fax:
Practice Address - Street 1:970 SANDERS RD STE 100
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5979
Practice Address - Country:US
Practice Address - Phone:404-920-4950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty