Organization
SOUTHEAST REGIONAL PAIN CTR PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH BARNGROVER DO (PRESIDENT)
(706) 571-7246
Entity
Organization
Contact information
Practice address
5669 WHITESVILLE ROAD, COLUMBUS, GA 31904
(706) 571-7246
(706) 571-8820
Mailing address
PO BOX 7757, COLUMBUS, GA 31908-7757
(706) 571-7246
(706) 563-8287
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
027027
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000296777E
—
GA
Enumeration date
08/29/2006
Last updated
02/14/2017
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