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Organization

PAIN ASSOCIATES OF SOUTH GEORGIA,LLC

Active
Other names
Pain Associates of South Georgia
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL J LUPI DO (OWNER)
(912) 267-9000
Entity
Organization

Contact information

Practice address
3408 TROUT STREET, BRUNSWICK, GA 31520-3622
(912) 267-9000
(912) 267-9028
Mailing address
3408 TROUT STREET, BRUNSWICK, GA 31520-3622
(912) 267-9000
(912) 267-9028

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
038152
GA
208VP0014X
Interventional Pain Medicine Physician
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DC0767
RR MEDICARE GROUP
GA
Enumeration date
08/31/2006
Last updated
04/06/2010
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