Georgia Mua, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

041961 Issued in GA

Legal business name

GEORGIA MUA, LLC

Practice address

1276 McConnell Dr
Ste. a&B
Decatur, GA 30033-3508

Phone

(404) 348-4348

Fax

(877) 451-8595

NPI assigned

Sep 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Smith, MD

Title

Member

Phone

(404) 788-6140

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1871741389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 MCCONNELL DR",
            "address_2": "STE. A&B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 MCCONNELL DR",
            "address_2": "STE. A&B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333508",
            "telephone_number": "404-348-4348",
            "fax_number": "877-451-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MUA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "404-788-6140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "008268",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "041961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.