Individual
JEREMY JACOB PRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 RIVERSIDE DR, BLDG C, MACON, GA 31210-2550
(478) 474-2947
(478) 971-4004
Mailing address
3200 RIVERSIDE DR, BLDG C, MACON, GA 31210-2550
(478) 474-2947
(478) 971-4004
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
071618
GA
208VP0000X
Pain Medicine Physician
071618
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
L071618
GA
Other
Enumeration date
04/23/2009
Last updated
10/22/2014
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