Organization
UROLOGY CLINIC NORTHWEST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE G MYGATT M.D. (OWNER)
(770) 942-5227
Entity
Organization
Contact information
Practice address
8954 HOSPITAL DR, SUITE 115D, DOUGLASVILLE, GA 30134-2272
(770) 942-5227
Mailing address
3025 BRECKINRIDGE BLVD, SUITE 120, DULUTH, GA 30096-7611
(678) 226-0022
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
020462
GA
Other
Enumeration date
05/08/2006
Last updated
08/22/2020
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