M & M Interventional Spine

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

058527 Issued in GA

Legal business name

M & M INTERVENTIONAL SPINE

Practice address

91 Sammy McGhee Blvd Ste 101
Jasper, GA 30143-7704

Phone

(706) 253-3367

Fax

(706) 253-3361

NPI assigned

Mar 8, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sallu Jabati

Title

Medical Director

Phone

(678) 559-4526

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1205134673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 SAMMY MCGHEE BLVD STE 101",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301437704",
            "telephone_number": "706-253-3367",
            "fax_number": "706-253-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 SAMMY MCGHEE BLVD STE 101",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301437704",
            "telephone_number": "706-253-3367",
            "fax_number": "706-253-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & M INTERVENTIONAL SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "JABATI",
        "authorized_official_first_name": "SALLU",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "678-559-4526"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "058527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L Lindsey III
• Cassie W Logan, PT
• Frank Clark Lopez, M.D.
• Camlyn Lowe, FNP-BC
• Michael Edward Lynch Sr., MD
• Ismarie Mabry, LCSW
• Khawaja R Mahmood, M.D.
• Patrick S Malone, DPM
• Karl Mareth, MD
• Kimberly Lisle Martin, LPC

• Interventional Pain Medicine Physician in Jasper, GA
• Providers in Jasper, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.