Organization
THE EMORY CLINIC INC
Active
Other names
Emory Center for Pain Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE MASON (OPERATIONS ADMINISTRATOR)
(404) 778-5639
Entity
Organization
Contact information
Practice address
550 PEACHTREE ST, ATLANTA, GA 30308
(404) 686-2410
Mailing address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-5639
(404) 778-0019
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
060277
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111236ASCA
MEDICARE FACILITY NUMBER
GA
Enumeration date
07/01/2006
Last updated
12/07/2007
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