Organization
SOUTHERN INTERVENTIONAL PAIN CENTER LLC
Active
Parent organization
SOUTHERN INTERVENTIONAL PAIN CENTER LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN INTERVENTIONAL PAIN CENTER LLC
Authorized official
MAXIMILIAN SHAHRYAR SHOKAT DO (MANAGING MEMBER)
(229) 226-2234
Entity
Organization
Contact information
Practice address
619 SW BAYA DR STE 102, LAKE CITY, FL 32025-4204
(386) 361-3400
(855) 313-1262
Mailing address
615 S HANSELL ST, THOMASVILLE, GA 31792-5556
(229) 226-2234
(229) 226-2237
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/14/2019
Last updated
01/31/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us