Individual
OTTO GOYCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 SANDERS RD, SUITE B, CUMMING, GA 30041-5960
(770) 781-8840
(770) 781-8098
Mailing address
4074 BOGAN BLUFF LN, BUFORD, GA 30519-4501
(678) 482-6886
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042473
GA
Other
Enumeration date
11/21/2005
Last updated
07/08/2007
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