Organization
SOUTHEASTERN INTERVENTIONAL PAIN ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUTHER C ROLLINS MD (PARTNER)
(770) 558-8501
Entity
Organization
Contact information
Practice address
1150 HAMMOND DR BLDG E40, ATLANTA, GA 30328
(770) 558-8501
(770) 558-8512
Mailing address
1150 HAMMOND DR BLDG E40, ATLANTA, GA 30328-5334
(770) 558-8501
(770) 558-8512
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
027825
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G707260
MEDICARE
GA
Enumeration date
11/23/2009
Last updated
07/27/2018
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