Healthcare Provider Details

I. General information

NPI: 1851449540
Provider Name (Legal Business Name): RADIOTHERAPY CLINICS OF GEORGIA,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 LAWRENCEVILLE HWY
DECATUR GA
30033-3143
US

IV. Provider business mailing address

PO BOX 116470
ATLANTA GA
30368-6470
US

V. Phone/Fax

Practice location:
  • Phone: 404-320-1550
  • Fax: 404-636-8030
Mailing address:
  • Phone: 770-682-2080
  • Fax: 678-579-9398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FRANK CRITZ
Title or Position: PHYSICIAN
Credential: MD
Phone: 770-682-2080