1. Home
  2. Directory
  3. Georgia
  4. Atlanta
  5. Specialist
  6. NPI Profile

SOUTHERN SPINE & PAIN INSTITUTE
NPI 1639584378
Specialist in Atlanta, GA

Active since June 20, 2014
3886 PRINCETON LAKES WAY SW, STE 240, ATLANTA, GA 30331(770) 632-3730(770) 632-3731 Get Directions Write a Review

NPPES record last updated: June 20, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southern Spine & Pain Institute NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN SPINE & PAIN INSTITUTE (NPI 1639584378) is a healthcare organization registered as a specialist in Atlanta, Georgia and active in the NPI registry since June 2014. The organization lists Anthony Thaddeus Clavo, President/owner, as its authorized official.

NPPES Registry Identity

NPI1639584378
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHERN PAIN INSTITUTE, PC
Location Address3886 PRINCETON LAKES WAY SW, STE 240Atlanta, GA 30331-5511
Mailing AddressPo Box 740209, Lockbox Dept 40257Atlanta, GA 30374-0209 · (770) 632-3730 · Fax (770) 632-3731
Phone(770) 632-3730
Fax(770) 632-3731
Organization SubpartNo
Authorized OfficialAnthony Thaddeus ClavoPresident/owner · (770) 632-3730
Enumeration DateJune 20, 2014
✔ NPI 1639584378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in GA · 045425
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3886 PRINCETON LAKES WAY SW, Atlanta, GA 30331
Open in Google Maps ↗

Other Names 1

Doing Business AsSouthern Spine & Pain Institute

Other Identifiers 3

Other208VP0014XGA · Pain Medicine-interventional Pain Medicine Taxonomy
OtherGRP6066GA · Medicare Id
Medicare UPING72848GA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GEORGIA CANCER SPECIALISTS I, PC
Internal Medicine (Hematology & Oncology)
3886 PRINCETON LAKES WAY SW, SUITE 200
ATLANTA, GA 30331
Fulton County (404) 349-7300
LIFE CYCLE OB/GYN, LLC
Obstetrics & Gynecology
3886 PRINCETON LAKES WAY SW, SUITE 160
ATLANTA, GA 30331
Fulton County (404) 530-3060
PRESTIGE HEALTHCARE ATLANTA, LLC
Obstetrics & Gynecology
3886 PRINCETON LAKES WAY SW, SUITE 280
ATLANTA, GA 30331
Fulton County (404) 346-7100
TRINITY PHARMACY ENTERPRISE II LLC
Pharmacist
3886 PRINCETON LAKES WAY SW, 180
ATLANTA, GA 30331
Fulton County (404) 343-1624
DR. LORENZA A. SIMMONS M.D.
Obstetrics & Gynecology
3886 PRINCETON LAKES WAY SW, SUITE 280
ATLANTA, GA 30331
Fulton County (404) 346-7100
PROVIDENCE FOOT & ANKLE CENTERS, P.C. INC.
Podiatrist (Foot & Ankle Surgery)
3886 PRINCETON LAKES WAY SW, SUITE 140A
ATLANTA, GA 30331
Fulton County (770) 745-4224
HEAD-TO-TOE MEDICAL SUPPLIES, LLC
Durable Medical Equipment & Medical Supplies
3886 PRINCETON LAKES WAY SW, SUITE 140-B
ATLANTA, GA 30331
Fulton County (770) 745-4224
DR. TYRA CARTHENA HARRIS M.D.
Family Medicine
3886 PRINCETON LAKES WAY SW, SUITE 120
ATLANTA, GA 30331
Fulton County (404) 389-1234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Pain Institute, PC's NPI number?

The NPI number for Southern Pain Institute, PC is 1639584378. It was assigned to this organization in the NPPES registry on June 20, 2014. The provider is doing business as Southern Spine & Pain Institute.

Where is Southern Pain Institute, PC located?

Southern Pain Institute, PC is located at 3886 Princeton Lakes Way SW Ste 240, Atlanta, GA 30331. The listed phone number is (770) 632-3730.

What is Southern Pain Institute, PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Southern Pain Institute, PC was last updated on June 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.