OrganizationActive
Southeast Rehabilitation Corp
NPI 1093727067 · Pain Medicine (Physical Medicine & Rehabilitation) Physician · Macon, GA
Provider details
- NPI number
- 1093727067
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Victoria Mansour, Owner(478) 477-2314
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3312 Northside Dr Ste A110
Macon, GA 31210-2520
Phone: (478) 477-2314
Fax: (478) 477-3599
Street-level locationGet directions
Mailing address
3312 Northside Dr Ste A110
Macon, GA 31210-2520
Registry dates
- Enumerated
- 2006-08-11
- Last updated
- 2007-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.