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Organization
THE EMORY CLINIC INC
Active
Organization
THE EMORY CLINIC INC
Active
Other names
Emory Center for Pain Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE MASON (OPERATIONS ADMINISTRATOR)
(404) 778-5639
Entity
Organization
Contact information
Practice address
550 PEACHTREE ST, ATLANTA, GA 30308
(404) 686-2410
Mailing address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-5639
(404) 778-0019
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
060277
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111236ASCA
MEDICARE FACILITY NUMBER
GA
Enumeration date
07/01/2006
Last updated
12/07/2007
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