# NORTHWEST GEORGIA MEDICAL CLINIC, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053462325
- **Authorized official:** MRS. ANGIE SMITH (FINANCIAL COORD)
- **Authorized official phone:** (706) 378-5651

## Contact information

- **Practice address:** 15 RIVERBEND DR SW, STE 200, ROME, GA 30161-6065
- **Practice address phone:** (706) 378-5651
- **Practice address fax:** (706) 378-8267
- **Mailing address:** 15 RIVERBEND DR SW, STE 200, ROME, GA 30161-6065
- **Mailing address phone:** (706) 378-5651
- **Mailing address fax:** (706) 378-8267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2007
- **Last updated:** 04/08/2024