Urology Clinic Northwest, PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

020462 Issued in GA

Legal business name

UROLOGY CLINIC NORTHWEST, PC

Practice address

8954 Hospital Dr
Suite 115D
Douglasville, GA 30134-2272

Phone

(770) 942-5227

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

George G Mygatt, M.D.

Title

Owner

Phone

(770) 942-5227

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851340871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 BRECKINRIDGE BLVD",
            "address_2": "SUITE 120",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300967611",
            "telephone_number": "678-226-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8954 HOSPITAL DR",
            "address_2": "SUITE 115D",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342272",
            "telephone_number": "770-942-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY CLINIC NORTHWEST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MYGATT",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-942-5227",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "GA",
            "license": "020462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.