Organization
NORTHWEST NEUROLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY JAY KAPLAN M.D. (FINANCIAL OFFICER)
(770) 819-1717
Entity
Organization
Contact information
Practice address
4460 AUSTELL RD, AUSTELL, GA 30106-1844
(770) 941-4716
(770) 941-3047
Mailing address
3875 AUSTELL RD, SUITE 204, AUSTELL, GA 30106-1103
(770) 819-1717
(770) 819-1140
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
012499
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB2386
RAILROAD MEDICARE
—
Enumeration date
12/11/2006
Last updated
12/03/2010
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