NPI 1730110131

Northlake Physician Practice Network, INC.

Organisation Gynecologic Oncology Physician Tucker, GA

Practice location

Address: 1459 Montreal Rd Suite 408, Tucker, GA 30084-6900
Phone: (770) 938-3440

Authorised official

Name: Mark Pickett
Title: Vp
Phone: (770) 938-3440

Registered specialties

Gynecologic Oncology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207VX0201X

Other Obstetrics & Gynecology providers in Georgia →

Registry record

NPI: 1730110131
Entity type: Organization
NPI issued: 5 Jul 2006
Record last updated: 29 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.