Organization
NORTHWEST GEORGIA MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGIE SMITH (FINANCIAL COORD)
(706) 378-5651
Entity
Organization
Contact information
Practice address
15 RIVERBEND DR SW, STE 200, ROME, GA 30161-6065
(706) 378-5651
(706) 378-8267
Mailing address
15 RIVERBEND DR SW, STE 200, ROME, GA 30161-6065
(706) 378-5651
(706) 378-8267
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL0326
RAILROAD MEDICARE
GA
Enumeration date
01/15/2007
Last updated
04/08/2024
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