MEDICARE: TMG NORTHWEST GEORGIA ONCOLOGY CENTER INC

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	207RX0202X	Medical Oncology Physician

General Provider Information

NPI Number	:	1932728326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TMG NORTHWEST GEORGIA ONCOLOGY CENTER INC

Provider Business Mailing Address
First Line	:	100 GREENWAY BLVD FL 2
Second Line	:
City	:	CARROLLTON
State	:	GA
Zip	:	30117-4338
Country	:	US
Telephone Number	:	770-838-8710
Fax Number	:	770-812-5735

Provider Business Practice Location Address
First Line	:	705 DALLAS HWY STE 204
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-1243
Country	:	US
Telephone Number	:	770-333-2220
Fax Number	:	770-771-5931

Authorized Official
Title or Position	:	SR VP
Name	:	CLINT HOFFMAN
Credential	:
Telephone Number	:	770-838-8302

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	02/29/2024

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