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Organization

LAKESIDE PAIN CENTER, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DWAYNE LEE CLAY (MD)
(478) 475-9220
Entity
Organization

Contact information

Practice address
701 E US HIGHWAY 80 STE C, BLOOMINGDALE, GA 31302-0078
(478) 475-9220
(478) 475-9201
Mailing address
701 E US HIGHWAY 80 STE C, BLOOMINGDALE, GA 31302-0078
(478) 475-9220
(478) 475-9201

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
042215
GA
208VP0000X
Pain Medicine Physician
042215
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
042215
GA

Other

Enumeration date
08/15/2006
Last updated
05/13/2026
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