Provider Demographics
NPI:1689934093
Name:SURGICAL ONCOLOGY OF NORTH GEORGIA, INC.
Entity type:Organization
Organization Name:SURGICAL ONCOLOGY OF NORTH GEORGIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-661-3330
Mailing Address - Street 1:405 BMH CANCER CENTER
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804
Mailing Address - Country:US
Mailing Address - Phone:865-681-4800
Mailing Address - Fax:
Practice Address - Street 1:1218 W PACES FERRY RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2308
Practice Address - Country:US
Practice Address - Phone:865-661-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty