Organization
NORTHWEST GEORGIA ONCOLOGY CENTERS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE J. GOULD M.D. (M.D./ MEDICAL DIRECTOR)
(770) 281-5100
Entity
Organization
Contact information
Practice address
2500 HOSPITAL BOULEVARD, SUITE 490, ROSWELL, GA 30076-4907
(470) 321-7500
(678) 355-4474
Mailing address
1700 HOSPITAL SOUTH DRIVE, SUITE 300, AUSTELL, GA 30106-8116
(770) 944-2830
(678) 581-7170
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154864841
NPI NUMBER
GA
Enumeration date
11/29/2016
Last updated
01/04/2017
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