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General NPI Number Information
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NPI Number | 1790973576
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Entity Type | Individual
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Provider Name | NORMA ELLEN GADDY M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 970 JOE FRANK HARRIS PKWY SE SUITE 220
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2159
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Country | US
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Telephone | 770-607-8111
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Fax | 770-607-4111
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Provider Business Mailing Address
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Address Line | 970 JOE FRANK HARRIS PKWY SE STE 220
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2161
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Country | US
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Telephone | 770-607-8111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 042248
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 042248
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License Number State | GA
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