Individual
DR. JOHN GARGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 PHILIP BLVD, LAWRENCEVILLE, GA 30045-8733
(770) 995-3000
(770) 995-1427
Mailing address
PO BOX 116470, ATLANTA, GA 30368-6470
(770) 682-2080
(678) 579-9398
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
039105
GA
2085R0001X
Radiation Oncology Physician
Primary
39105
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000628075H
—
GA
05
—
000628075J
—
GA
05
—
000628075N
—
GA
05
—
000628075U
—
GA
Enumeration date
12/05/2005
Last updated
02/15/2016
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