# AUGUSTA INTERVENTIONAL PAIN AND REHABILITATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215201355
- **Authorized official:** DR. VENKATA LAKKIMSETTY MD (PHYSICIAN)
- **Authorized official phone:** (419) 508-4608

## Contact information

- **Practice address:** 1355 INDEPENDENCE DR, AUGUSTA, GA 30901-1037
- **Practice address phone:** (419) 508-4608
- **Mailing address:** 720 BON AIR DR, AUGUSTA, GA 30907-4872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 67138 | GA | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 67138 | GA | — |

## Other

- **Enumeration date:** 03/07/2012
- **Last updated:** 03/07/2012