Azar, Gordon Jerome
Azar, Gordon Jerome is an individual health care provider with primary practice located at 460 Northside Cherokee Blvd Ste 150 , Canton GA 30115-8018. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Azar, Gordon Jerome can be contacted via phone (470) 639-6250.Contact Information
Primary practice address
460 Northside Cherokee Blvd Ste 150
Canton GA 30115-8018
Phone: (470) 639-6250
Fax: (770) 345-0712
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 31380 | Georgia |
Profile Details
| NPI number | 1144210642 |
|---|---|
| LBN Legal business name | Azar, Gordon Jerome |
| Credentials | M.D., F.A.C.C. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Feb 16th, 2024 - about 7 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144210642 | NPPES |
| Georgia | MEDICAID | 00433815C |
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