Organization
ADVANCED SPINE & PAIN INTERVENTIONS, LLC
Active
Other names
Advanced Spine & Pain Interventions
Organization subpart
No
Provider details
NPI number
Authorized official
WOODLEY B. MARDY-DAVIS MD (MEDICAL DIRECTOR)
(470) 299-1998
Entity
Organization
Contact information
Practice address
12389 CRABAPPLE RD, ALPHARETTA, GA 30004-6328
(470) 299-1998
(470) 299-1898
Mailing address
12389 CRABAPPLE RD, ALPHARETTA, GA 30004-6328
(470) 299-1998
(470) 299-1898
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
059463
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
059463
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152738
PK
—
Enumeration date
11/19/2014
Last updated
04/23/2024
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