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Organization
GEORGIA CANCER TREATMENT AND HEMATOLOGY CENTER
Active
Organization
GEORGIA CANCER TREATMENT AND HEMATOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD ALAN GOLDKLANG MD (MEDICAL DIRECTOR)
(770) 719-1299
Entity
Organization
Contact information
Practice address
1279 HWY 54 W, SUITE 210, FAYETTEVILLE, GA 30215
(770) 719-1299
(770) 719-9244
Mailing address
483 UPPER RIVERDALE RD, STE E, RIVERDALE, GA 30274
(770) 909-1550
(770) 909-1535
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
020714
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00188801C
—
GA
Enumeration date
01/18/2006
Last updated
03/07/2023
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