OrganizationActive
Lakeside Pain Center, P.C.
NPI 1477566727 · Interventional Pain Medicine Physician · Bloomingdale, GA
Provider details
- NPI number
- 1477566727
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Dwayne Clay, MD(478) 475-9220
- License
- 042215 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(95/100 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
2 documented practice locations
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
701 E US Highway 80 Ste C
Bloomingdale, GA 31302-0078
Phone: (478) 475-9220
Fax: (478) 475-9201
Street-level locationGet directions
Mailing address
701 E US Highway 80 Ste C
Bloomingdale, GA 31302-0078
Additional practice locations (1)
- 125 Plantation Centre Dr S Ste 750aMacon, GA 31210-2091Phone: (478) 475-9220
Registry dates
- Enumerated
- 2006-08-15
- Last updated
- 2026-05-13
- Certified
- 2026-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.