Organization
THE HEMLOCK PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN N. TAFOR MD (PRESIDENT)
(478) 745-2385
Entity
Organization
Contact information
Practice address
101 PRESTON COURT, SUITE 103, MACON, GA 31210-5771
(478) 745-2385
(478) 745-1225
Mailing address
101 PRESTON COURT, SUITE 103, MACON, GA 31210-5771
(478) 745-2385
(478) 745-1225
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
GA
208VP0000X
Pain Medicine Physician
—
GA
208VP0014X
Interventional Pain Medicine Physician
—
GA
363AS0400X
Surgical Physician Assistant
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
482417805A
—
GA
01
—
DD0909
RAILROAD MEDICARE
GA
Enumeration date
05/06/2006
Last updated
08/18/2020
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