Organization · Type 2 NPI

Specialty Spine and Pain, PC

Interventional Pain Medicine Physician · Gainesville, GA

NPI number 1174164529 Active

Practice location

1240 Jesse Jewell Pkwy SE Ste 300
Gainesville, GA 30501-3861

Call (770) 534-7200 Map

Fax (770) 536-0617

Mailing address

4960 SW 72nd Ave Ste 405
Miami, FL 33155-5506

Specialties and licenses

TaxonomyCodeLicense
Interventional Pain Medicine Physician Primary 208VP0014XNone listed

Interventional Pain Medicine Physician: 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.

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About NPI 1174164529

Specialty Spine and Pain, PC's National Provider Identifier is 1174164529, issued on Oct 7, 2019. The primary taxonomy on file is Interventional Pain Medicine Physician (208VP0014X), and the practice location is in Gainesville, GA. The record was last updated on Sep 17, 2025.