SOUTH ATLANTA NEUROLOGY & PAIN CLINIC PC NPI 1639331150

NPI Information

NPI: 1639331150
Provider Name: SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC

Other Name: OPEN MRI OF SANPC

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
1040 EAGLES LANDING PKWY
STE 102
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 507-7359
Get Directions

SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC is a neurology psychiatry neurology in Stockbridge, GA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC NPI is 1639331150. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Open Mri Of Sanpc.

The provider's business location address is:

1040 EAGLES LANDING PKWY
STE 102
STOCKBRIDGE, GA
ZIP 30281-073
Phone: (770) 507-7359
Fax: (770) 507-8390

The provider's authorized official is Brice Byung-il Choi .
The authorized official title is Owner/president and has the following contact phone number (770) 507-7359.

The enumeration date for this NPI number is 6/26/2008 and was last updated on 1/19/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		044899	GEORGIA	No
2	2084P2900X	Psychiatry & Neurology	Pain Medicine			No
3	2085D0003X	Radiology	Diagnostic Neuroimaging			No
4	2085N0700X	Radiology	Neuroradiology			No
5	2085R0202X	Radiology	Diagnostic Radiology			No
6	2085R0203X	Radiology	Therapeutic Radiology			No
7	208VP0000X	Pain Medicine	Pain Medicine			No
8	2084N0400X	Psychiatry & Neurology	Neurology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000783989F	MEDICAID	GEORGIA
2	E48180	MEDICARE UPIN	GEORGIA
3	5722690001	MEDICARE NSC	GEORGIA
4	13BDDDK	MEDICARE PIN	GEORGIA
5	1174554455	OTHER	GEORGIA	INDIVIDUAL NPI #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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