Organization
NORTHWEST GEORGIA MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL GAVEL (ADMINISTRATOR)
(706) 625-0525
Entity
Organization
Contact information
Practice address
400 TIMMS RD NE, CALHOUN, GA 30701-7016
(706) 625-0022
(706) 625-3988
Mailing address
400 TIMMS RD NE, CALHOUN, GA 30701-7016
(706) 625-0022
(706) 625-4563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260696827A
—
GA
Enumeration date
09/22/2006
Last updated
06/19/2012
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