East Georgia Pain Management Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

052044 Issued in GA

Legal business name

EAST GEORGIA PAIN MANAGEMENT CENTER

Practice address

4119 Tate St NE
Covington, GA 30014-2554

Phone

(770) 784-3862

Fax

(770) 784-5989

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Tovie Nichole Duke

Title

Office Manager

Phone

(770) 784-3862

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1942486832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 TATE ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142554",
            "telephone_number": "770-784-3862",
            "fax_number": "770-784-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 TATE ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142554",
            "telephone_number": "770-784-3862",
            "fax_number": "770-784-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST GEORGIA PAIN MANAGEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "TOVIE",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-784-3862"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "052044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Covington, GA
• Providers in Covington, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.