Organization
PAIN TREATMENT CENTERS OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VADIM PETROV-KONDRATOV (OWNER/MD)
(912) 910-3777
Entity
Organization
Contact information
Practice address
303 S MAIN ST, SWAINSBORO, GA 30401-3613
(912) 910-3777
(912) 292-0005
Mailing address
604 W OGLETHORPE HWY, HINESVILLE, GA 31313-4415
(912) 910-3777
(912) 292-0005
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/16/2025
Last updated
12/16/2025
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