SOUTHERN PAIN INSTITUTE PC (NPI# 1609913318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609913318 |
| Entity Type | Organization |
| Organization Name | SOUTHERN PAIN INSTITUTE PC |
| Practice Address |
1501 Milstead Rd Ne Suite 140 Conyers GA 30012-3838 |
| Mailing Address |
1975 Highway 54 W Suite 100 Peachtree City GA 30269-4794 |
| Practice Telephone | 7706323730 |
| Practice Fax Number | 7706323731 |
| Mailing Telephone | 7706323730 |
| Mailing Fax Number | 7706323731 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2015-07-30 |
| Authorized Official Name | ANTHONY T CLAVO SR. (CEO) |
| Authorized Official Telephone | 7706323730 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
045425 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1501 MILSTEAD RD NE SUITE 140 |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215942941 | Georgia Cancer Specialists I PC | Internal Medicine | 1501 Milstead Rd Ne, Suite 110, Conyers, GA 30012-3835 | 2006-07-30 |
| 1043639545 | Meghana Bhatta Kumar | Internal Medicine | 1501 Milstead Rd Ne, Conyers, GA 30012-3838 | 2014-04-11 |
| 1932450004 | Nsh Cancer Institute Professional Services G, LLC | Durable Medical Equipment & Medical Supplies | 1501 Milstead Rd Ne, Suite 110, Conyers, GA 30012-3838 | 2012-09-28 |
| 1720314776 | Wilder Dialysis LLC | Clinic/Center | 1501 Milstead Rd Ne, Conyers, GA 30012-3838 | 2009-10-27 |
| 1861654840 | David S Rabin | Internal Medicine | 1501 Milstead Rd Ne, Ste 120, Conyers, GA 30012-3838 | 2008-06-30 |
| 1710198577 | Sherine J Thomas | Internal Medicine | 1501 Milstead Rd Ne, Suite 110, Conyers, GA 30012-3838 | 2007-05-24 |
| 1710199831 | Nader A Dbouk | Internal Medicine | 1501 Milstead Rd Ne, Suite 120, Conyers, GA 30012 | 2007-05-03 |
| 1316163975 | Angelo J Rizzo | Physical Therapist | 1501 Milstead Rd Ne, Ste 170, Conyers, GA 30012-3838 | 2007-04-18 |
| 1962505743 | Therapeutic Solutions, Inc | Physical Therapist | 1501 Milstead Rd Ne, Ste 170, Conyers, GA 30012-3838 | 2006-09-06 |
| 1679686661 | Kevin H Peacock | Internal Medicine | 1501 Milstead Rd Ne, Suite 110, Conyers, GA 30012-3838 | 2006-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235185141 | Robin J. Fowler | Pain Medicine | 1388 Wellbrook Cir Ne, Suite A, Conyers, GA 30012-3872 | 2006-05-25 |
| 1023481918 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 1388 Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2015-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891302998 | Apollo Spine and Pain Center | Pain Medicine | 4415 Front Nine Dr, Cumming, GA 30041-6063 | 2020-09-23 |
| 1235756792 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 2100 Central Ave Ste 6, Augusta, GA 30904-6709 | 2020-07-01 |
| 1902433147 | Sun Pain Institute LLC | Pain Medicine | 836 E 65th St Ste 38, Savannah, GA 31405-4495 | 2020-03-26 |
| 1679107338 | Atlanta Interventional Pain Management, LLC | Pain Medicine | 13190 Highway 92 Ste 120, Woodstock, GA 30188-4406 | 2020-03-02 |
| 1578193355 | Regenerative Spine and Pain Specialists | Pain Medicine | 874 Lanier Ave W Ste 250, Fayetteville, GA 30214-7662 | 2020-01-22 |
| 1437790839 | Specialty Spine and Pain, PC | Pain Medicine | 1498 Jesse Jewell Pkwy Se Ste D, Gainesville, GA 30501-3874 | 2019-10-07 |
| 1154962165 | Specialty Spine and Pain, PC | Pain Medicine | 2695 Old Winder Hwy Ste 150, Braselton, GA 30517-6076 | 2019-10-01 |
| 1659912665 | Specialty Spine and Pain, PC | Pain Medicine | 5005a Lanier Islands Pkwy Ste 100, Buford, GA 30518-1802 | 2019-10-01 |
| 1114578515 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Highway 53 E Ste 110, Dawsonville, GA 30534-6227 | 2019-09-26 |
| 1477106771 | Spine Center of Southeast Georgia LLC | Pain Medicine | 52a Lindsey Lane, Kingsland, GA 31548-6855 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHERN PAIN INSTITUTE PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.