Organization
SOUTHERN PAIN INSTITUTE, PC
Active
Other names
Southern Pain & Diagnostics Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY THADDEUS CLAVO SR. M.D. (PRESIDENT)
(770) 632-3730
Entity
Organization
Contact information
Practice address
1975 HIGHWAY 54 W, SUITE 100, PEACHTREE CITY, GA 30269-4794
(770) 632-3730
(770) 632-3731
Mailing address
1975 HIGHWAY 54 W, SUITE 100, PEACHTREE CITY, GA 30269-4794
(770) 632-3730
(770) 632-3731
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
045425
GA
Other
Enumeration date
10/02/2006
Last updated
07/27/2015
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