Provider Demographics
NPI:1851449540
Name:RADIOTHERAPY CLINICS OF GEORGIA,LLC
Entity Type:Organization
Organization Name:RADIOTHERAPY CLINICS OF GEORGIA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-682-2080
Mailing Address - Street 1:PO BOX 116470
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6470
Mailing Address - Country:US
Mailing Address - Phone:770-682-2080
Mailing Address - Fax:678-579-9398
Practice Address - Street 1:2349 LAWRENCEVILLE HWY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3143
Practice Address - Country:US
Practice Address - Phone:404-320-1550
Practice Address - Fax:404-636-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7940Medicare PIN