Individual
DR. GORDON JEROME AZAR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.C.
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 150, CANTON, GA 30115-8018
(470) 639-6250
(770) 345-0712
Mailing address
460 NORTHSIDE CHEROKEE BLVD STE 150, CANTON, GA 30115-8018
(470) 639-6250
(770) 345-0712
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
31380
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00433815C
—
GA
Enumeration date
10/26/2005
Last updated
02/16/2024
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