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

Southside Medical & Physical Therapy, LLC

Organization Interventional Pain Medicine Physician · NPI 1063628675

Southside Medical & Physical Therapy, LLC is an Interventional Pain Medicine Physician in Fayetteville, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1415 Highway 85 N Ste 310-314
Fayetteville, GA 30214-4035
Phone: (866) 476-8913
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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 054590 (GA)

Record details

NPI number1063628675
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Steven Lobel — Medical Director · (866) 476-8913
NPI enumeratedMay 14, 2007
Last updated in NPPESOctober 29, 2007
Mailing address1415 Highway 85 N, Suite 310-314, Fayetteville, GA 30214-4035

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