Provider Demographics
NPI:1730545674
Name:PAIN CENTER AT PIEDMONT LLC. ASC
Entity type:Organization
Organization Name:PAIN CENTER AT PIEDMONT LLC. ASC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-782-7999
Mailing Address - Street 1:1740 HUDSON BRIDGE RD
Mailing Address - Street 2:SUITE 1211
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6331
Mailing Address - Country:US
Mailing Address - Phone:678-782-7999
Mailing Address - Fax:
Practice Address - Street 1:1050 EAGLES LANDING PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9018
Practice Address - Country:US
Practice Address - Phone:678-782-7999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain