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Organization
NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC
Active
Organization
NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
(404) 851-6968
Entity
Organization
Contact information
Practice address
1240 JESSE JEWELL PKWY SE STE 500, GAINESVILLE, GA 30501-3861
(855) 709-4535
Mailing address
1100 JOHNSON FY RD NE STE 780, ATLANTA, GA 30342-1743
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/03/2018
Last updated
09/03/2026
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