# NORTHEAST GEORGIA DIAGNOSTIC CLINIC LLC

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

## Provider details

- **NPI number:** 1215976634
- **Authorized official:** MARGARET GASKILL (REVENUE CYCLE DIRECTOR)
- **Authorized official phone:** (770) 536-9864

## Contact information

- **Practice address:** 1240 JESSE JEWELL PKWY SE, SUITE 500, GAINESVILLE, GA 30501-3862
- **Practice address phone:** (770) 536-9864
- **Practice address fax:** (770) 297-5023
- **Mailing address:** 1240 JESSE JEWELL PKWY SE, SUITE 500, GAINESVILLE, GA 30501-3862
- **Mailing address phone:** (770) 536-9864
- **Mailing address fax:** (770) 297-5023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 09/20/2017