Organization
THE HEMLOCK PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN N. TAFOR MD (PRESIDENT)
(478) 745-2385
Entity
Organization
Contact information
Practice address
500 W MAIN ST, THOMASTON, GA 30286-6209
(706) 307-6055
(478) 745-1225
Mailing address
101 PRESTON CT STE 103, MACON, GA 31210-5771
(478) 745-2385
(478) 745-1225
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
482417805A
—
GA
Enumeration date
08/10/2020
Last updated
08/19/2020
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