PHYSICIAN DISABILITY EXAMINATION SERVICES INC NPI 1740587641

NPI Information

NPI: 1740587641
Provider Name: PHYSICIAN DISABILITY EXAMINATION SERVICES INC

Doing Business As: DANIA BEACH WEST MEDICINE AND REHAB

Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

CLIA Number: 11D2120612

Address:
507 W 3RD AVE STE 8A
ALBANY, GA
ZIP 31701
Phone: (888) 589-9064
Get Directions

PHYSICIAN DISABILITY EXAMINATION SERVICES INC is a pain clinic center in Albany, GA. PHYSICIAN DISABILITY EXAMINATION SERVICES INC NPI is 1740587641. The provider is registered as an organization entity type.
The provider Is Doing Business As Dania Beach West Medicine And Rehab.

The provider's business location address is:

507 W 3RD AVE STE 8A
ALBANY, GA
ZIP 31701-945
Phone: (888) 589-9064

The provider's authorized official is Stanford Anthony Williamson .
The authorized official title is Ceo/owner and has the following contact phone number (888) 589-9064.

The CLIA number assigned to this NPI record is 11D2120612 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2011 and was last updated on 10/28/2022.

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	261QR0400X	Clinic/Center	Rehabilitation	OS10135	FLORIDA	No
2	261QP3300X	Clinic/Center	Pain			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	000-106-500	MEDICAID	FLORIDA

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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