Individual
JONATHAN GARRETT GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 E 2ND AVE, SUITE 103, ROME, GA 30161-3209
(706) 509-3278
(706) 509-4600
Mailing address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(706) 509-6100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
059417
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
622192462B
—
GA
Enumeration date
05/17/2007
Last updated
05/07/2012
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