Individual
GODLY OBOMATE JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 GENTILLY BLVD, CARTERSVILLE, GA 30120-8522
(470) 490-6670
(770) 382-5762
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
98756
GA
207RI0011X
Interventional Cardiology Physician
Primary
98756
GA
Other
Enumeration date
04/24/2017
Last updated
06/20/2024
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