Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Pain Institute PC

Organization Interventional Pain Medicine Physician · NPI 1609913318

Southern Pain Institute PC is an Interventional Pain Medicine Physician in Conyers, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1501 Milstead Rd NE Ste 140
Conyers, GA 30012-3838
Phone: (770) 632-3730
Fax: (770) 632-3731
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X · Licence 045425 (GA)

Record details

NPI number1609913318
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anthony Clavo — Ceo · (770) 632-3730
NPI enumeratedJanuary 31, 2007
Last updated in NPPESJuly 30, 2015
Mailing address1975 Highway 54 W, Suite 100, Peachtree City, GA 30269-4794

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