Northwest Georgia Oncology Centers, PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

074178000 Issued in GA

Legal business name

NORTHWEST GEORGIA ONCOLOGY CENTERS, PC

Practice address

15 Reinhardt College Pkwy
Suite 110
Canton, GA 30114-2493

Phone

(770) 720-7789

Fax

(770) 720-7784

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bruce J. Gould, MD

Title

MD Physician

Phone

(770) 281-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1992833941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "SUITE 300",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066810",
            "telephone_number": "770-944-2830",
            "fax_number": "678-581-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY",
            "address_2": "SUITE 110",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142493",
            "telephone_number": "770-720-7789",
            "fax_number": "770-720-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST GEORGIA ONCOLOGY CENTERS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MD PHYSICIAN",
        "authorized_official_telephone_number": "770-281-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "074178000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER NPI NUMBER (CANTON)",
            "identifier": "1992833941",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Canton, GA
• Providers in Canton, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.