East Georgia Cancer Clinic

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

51780 Issued in GA

Legal business name

EAST GEORGIA CANCER CLINIC

Practice address

1601 Fair Rd
#900
Statesboro, GA 30458-1698

Phone

(912) 871-8000

NPI assigned

May 16, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Harsh Bhushan

Title

Secretary

Phone

(912) 871-8000

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400284800000",
    "number": "1720499304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 FAIR RD",
            "address_2": "#900",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 FAIR RD",
            "address_2": "#900",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581698",
            "telephone_number": "912-871-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST GEORGIA CANCER CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-16",
        "last_updated": "2014-05-17",
        "status": "A",
        "authorized_official_last_name": "BHUSHAN",
        "authorized_official_first_name": "HARSH",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "912-871-8000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "51780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000958823",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Earsource Technologies LLC
• East Ga Regional Eye Center
• East Ga Regional Eye Center
• East Ga Specialty Pharmacy
• East Georgia Cancer Center
• East Georgia Center for Oral & Facial Surgery LLC
• East Georgia Counseling Services, Inc.
• East Georgia Diagnostic Services
• East Georgia Foot and Ankle Center
• East Georgia Healthcare Center Inc (Statesboro Pediatrics & Family Healthcare)

• Hematology & Oncology Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Hematology & Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.