MEDICARE: AMERICAN ONCOLOGY ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1386699205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN ONCOLOGY ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	3330 PRESTON RIDGE RD
Second Line	:	SUITE 300
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4508
Country	:	US
Telephone Number	:	770-350-0126
Fax Number	:	770-350-6637

Provider Business Practice Location Address
First Line	:	1000 COWLES CLINC WAY
Second Line	:	MAGNOLIA BLDG., SUITE M-100
City	:	GREENSBORO
State	:	GA
Zip	:	30642-5285
Country	:	US
Telephone Number	:	706-454-1624
Fax Number	:	706-454-1685

Authorized Official
Title or Position	:	CEO
Name	:	DALE LYNN MCCORD
Credential	:	MD
Telephone Number	:	770-350-0126

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	08/28/2014

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