Healthcare Provider Details

I. General information

NPI: 1831428044
Provider Name (Legal Business Name): ATLANTA ONCOLOGY ASSOCIATES AT ATLANTA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 PARKWAY DR NE
ATLANTA GA
30312-1213
US

IV. Provider business mailing address

3330 PRESTON RIDGE RD SUITE 300
ALPHARETTA GA
30005-4508
US

V. Phone/Fax

Practice location:
  • Phone: 404-522-6569
  • Fax: 404-522-8265
Mailing address:
  • Phone: 770-350-0126
  • Fax: 770-350-6637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DALE LYNN MCCORD
Title or Position: CEO
Credential: M.D.
Phone: 770-350-0126