Northlake Physician Practice Network INC

NPI #1285672220 in Tucker, Georgia

Provider Information

NPI Number: 1285672220
Entity Type: Organization
Organization Name: Northlake Physician Practice Network INC
Primary Specialty: Surgery - Surgical Oncology
Enumeration Date: Jun 3, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1459 MONTREAL RD
Address 2: 408
City: Tucker
State: Georgia
ZIP Code: 30084-6900
Phone: (770) 938-3440

Authorized Official

Name: MARK PICKETT
Title: VP
Phone: (678) 762-5037

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery - Surgical Oncology — Surgical Oncology	2086X0206X	Primary

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