Organization
MD PAIN CARE, P.C.
Active
Other names
Covington Anesthesia Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R L TALLEY JR. M.D. (PRESIDENT)
(770) 760-9360
Entity
Organization
Contact information
Practice address
1301 SIGMAN RD, SUITE 100, CONYERS, GA 30012-4515
(770) 760-9360
(770) 760-9303
Mailing address
1622 MARS HILL RD, STE C, WATKINSVILLE, GA 30677-4893
(706) 769-9633
(706) 769-9309
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028514
—
GA
Enumeration date
12/14/2006
Last updated
12/19/2012
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