Organization
NORTHWEST GEORGIA ONCOLOGY CENTERS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE J GOULD MD (MD PHYSICIAN)
(770) 281-5100
Entity
Organization
Contact information
Practice address
100 MARKET PLACE BLVD, STE 200, CARTERSVILLE, GA 30121-8718
(770) 386-7253
(770) 382-6424
Mailing address
1700 HOSPITAL SOUTH DR, SUITE 300, AUSTELL, GA 30106-6810
(770) 944-2830
(678) 581-7170
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0741780004
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083742175
NPI SUPPLIER NUMBER (CARTERSVILLE)
GA
Enumeration date
03/01/2007
Last updated
12/01/2010
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