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General NPI Number Information
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NPI Number | 1770528671
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Entity Type | Organization
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Legal Business Name | COBB CENTER FOR RADIATION THERAPY, INC.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1800 HOSPITAL SOUTH DR
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City | AUSTELL
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State | GA
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Zip | 30106-8114
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Country | US
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Telephone | 770-948-6000
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Fax | 770-948-2638
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Provider Business Mailing Address
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Address Line | 1800 HOSPITAL SOUTH DR
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City | AUSTELL
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State | GA
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Zip | 30106-8114
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Country | US
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Telephone | 770-948-6000
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Fax | 770-948-2638
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | NELDA H CHAMPAGNE
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Credential |
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Telephone | 770-907-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State | GA
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