Organization
PAVILION SPINE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAMAL C. KABAKIBOU M.D. (OWNER/PRESIDENT)
(404) 603-9090
Entity
Organization
Contact information
Practice address
3193 HOWELL MILL RD NW, STE. #315, ATLANTA, GA 30327-2119
(404) 603-9090
(404) 603-9634
Mailing address
3193 HOWELL MILL RD NW, STE. #315, ATLANTA, GA 30327-2119
(404) 603-9090
(404) 603-9634
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
GA
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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