Provider Demographics
NPI:1396927562
Name:ONCOLOGY & HEMATOLOGY
Entity type:Organization
Organization Name:ONCOLOGY & HEMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:G
Authorized Official - Last Name:GEDDES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:678-789-5236
Mailing Address - Street 1:PO BOX 54283
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-0283
Mailing Address - Country:US
Mailing Address - Phone:678-789-5236
Mailing Address - Fax:404-888-8881
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1075
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:678-789-5236
Practice Address - Fax:404-888-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045798174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00857447DMedicaid
GA045798OtherLICENSE
GA00857447DMedicaid