SOUTHEASTERN GYNECOLOGIC ONCOLOGY LLC NPI 1073584207

NPI Information

  • NPI: 1073584207
  • Provider Name: SOUTHEASTERN GYNECOLOGIC ONCOLOGY, LLC
  • Classification: Obstetrics & Gynecology - 207VX0201X
  • Specialization: Gynecologic Oncology
  • Entity Type: Organization
  • CLIA Number: 11D2282728
  • Address: 980 JOHNSON FERRY RD NE
    SUITE 900
    ATLANTA, GA
    ZIP 30342
  • Phone: (678) 420-4100

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NPI Details

SOUTHEASTERN GYNECOLOGIC ONCOLOGY, LLC is a gynecologic oncology obstetrics gynecology in Atlanta, GA. The provider is an obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. SOUTHEASTERN GYNECOLOGIC ONCOLOGY, LLC NPI is 1073584207. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

980 JOHNSON FERRY RD NE
SUITE 900
ATLANTA, GA
ZIP 30342-626
Phone: (678) 420-4100
Fax: (678) 420-4120

The provider's authorized official is Gerald Feuer .
The authorized official title is Doctor/partner and has the following contact phone number (678) 420-4100.

The CLIA number assigned to this NPI record is 11D2282728 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/27/2006 and was last updated on 7/10/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VX0201XObstetrics & GynecologyGynecologic OncologyYes

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This page was last updated on: 11/21/2025

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