NORTHLAKE PHYSICIAN PRACTICE NETWORK INC. NPI 1730110131

NPI Information

  • NPI: 1730110131
  • Provider Name: NORTHLAKE PHYSICIAN PRACTICE NETWORK, INC.
  • Classification: Obstetrics & Gynecology - 207VX0201X
  • Specialization: Gynecologic Oncology
  • Entity Type: Organization
  • Doing Business As: WOMEN'S CANCER ALLIANCE
  • Address: 1459 MONTREAL RD
    SUITE 408
    TUCKER, GA
    ZIP 30084
  • Phone: (770) 938-3440

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NPI Details

NORTHLAKE PHYSICIAN PRACTICE NETWORK, INC. is a gynecologic oncology obstetrics gynecology in Tucker, 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. NORTHLAKE PHYSICIAN PRACTICE NETWORK, INC. NPI is 1730110131. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Women's Cancer Alliance.

The provider's business location address is:

1459 MONTREAL RD
SUITE 408
TUCKER, GA
ZIP 30084-900
Phone: (770) 938-3440

The provider's authorized official is Mark Pickett .
The authorized official title is Vp and has the following contact phone number (770) 938-3440.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 8/29/2007.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP5096MEDICARE ID-TYPE UNSPECIFIEDGEORGIAGROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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