| Organization Name: | PHYSICIAN PAIN CARE,P.C. |
| NPI Number: | 1023273570 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY WILLIAM RUBIN (MEDICAL DIRECTOR) |
| Mailing Address: | 240 Heritage Walk Suite 101 Woodstock |
| State: | GA US |
| Postal Code: | 301883875 |
| Phone Number: | 7705167880 |
| Fax Number: | 7705167870 |
| NPI Enumeration Date: | 07/24/2008 |
| NPI Last Update Date: | 06/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | 030873 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |