Organization
THE HEMLOCK PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN NGWA TAFOR MD (PRESIDENT)
(478) 745-2385
Entity
Organization
Contact information
Practice address
504 OSIGIAN BLVD, SUITE 5, WARNER ROBINS, GA 31088-8012
(478) 745-2385
(478) 745-1225
Mailing address
PO BOX 116004, ATLANTA, GA 30368-6004
(706) 860-2701
(706) 860-6484
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
GA
208VP0000X
Pain Medicine Physician
—
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
—
GA
363A00000X
Physician Assistant
—
GA
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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