Bcgp

NPI #1619003902 in Lilburn, Georgia

Provider Information

NPI Number: 1619003902
Entity Type: Organization
Organization Name: Bcgp
Primary Specialty: Specialist
Enumeration Date: Feb 23, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 976 KILLIAN HILL RD SW
Address 2: BUILDING A, SUITE B
City: Lilburn
State: Georgia
ZIP Code: 30047-3102
Phone: (770) 923-6400

Authorized Official

Name: DR. GEORGE KATSITADZE, M.D.
Title: PHYSICIAN
Phone: (770) 923-6400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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