Organization
NORTH GEORGIA UROLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER OAKS (OFFICE MANAGER)
(706) 278-5961
Entity
Organization
Contact information
Practice address
1434 BROADRICK DR, DALTON, GA 30720-3009
(706) 278-5961
(706) 275-0280
Mailing address
1434 BROADRICK DR, DALTON, GA 30720-3009
(706) 278-5961
(706) 275-0280
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
050482
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6470
PTAN
GA
Enumeration date
10/14/2015
Last updated
10/14/2015
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