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Organization
GATES RAPID DIAGNOSTIC LABORATORY OF ATLANTA
Active
Organization
GATES RAPID DIAGNOSTIC LABORATORY OF ATLANTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON L. GATES M.D (OWNER)
(678) 591-6509
Entity
Organization
Contact information
Practice address
777 CLEVELAND AVE SW, SUITE 100, ATLANTA, GA 30315-7129
(404) 763-0093
Mailing address
1880 LANCASTER DRIVE, CONYERS, GA 30013
(678) 591-6509
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
038767
GA
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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