Organization
GEORGIA CANCER TREATMENT AND HEMATOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD ALAN GOLDKLANG MD (MEDICAL DIRECTOR)
(770) 719-1299
Entity
Organization
Contact information
Practice address
1279 HWY 54 W, SUITE 210, FAYETTEVILLE, GA 30215
(770) 719-1299
(770) 719-9244
Mailing address
483 UPPER RIVERDALE RD, STE E, RIVERDALE, GA 30274
(770) 909-1550
(770) 909-1535
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
020714
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00188801C
—
GA
Enumeration date
01/18/2006
Last updated
03/07/2023
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