Bradley J.g. Larson (NPI# 1194729582, PAC ID# 5395718746) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is HEMATOLOGY/ONCOLOGY.
| Nation Provider ID (NPI) | 1194729582 |
| PAC ID by PECOS | 5395718746 |
| Professional Enrollment ID | I20040816000084 |
| Full Name | Bradley J.g. Larson |
| Organization Legal Name | NORTHWEST GEORGIA ONCOLOGY CENTERS, PC |
| Address |
200 Allen Memorial Dr 302b Bremen GA 30110-2012 |
| Phone Number | 7708242222 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF WISCONSIN MEDICAL SCHOOL |
| Graduation Year | 1997 |
| Primary Specialty | HEMATOLOGY/ONCOLOGY |
| Group Practice PAC ID | 5395642284 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110011 | TANNER MEDICAL CENTER - CARROLLTON |
| 111320 | HIGGINS GENERAL HOSPITAL |
| 110015 | TANNER MEDICAL CENTER VILLA RICA |
| Address | Phone | Organization |
|---|---|---|
| 200 Allen Memorial Dr, 302b, Bremen, GA 30110-2012 | 7708242222 | NORTHWEST GEORGIA ONCOLOGY CENTERS, PC |
| 157 Clinic Ave, Suite 101, Carrollton, GA 30117-4413 | 7703532220 | NORTHWEST GEORGIA ONCOLOGY CENTERS, PC |
| Organization Legal Name | NORTHWEST GEORGIA ONCOLOGY CENTERS, PC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rosemary Taormina | Nurse Practitioner | Northwest Georgia Oncology Centers, PC | 340 Kennestone Hospital Blvd, Suite 200, Marietta, GA 30060-1170 |
| Gina D Duggar | Nurse Practitioner | Northwest Georgia Oncology Centers, PC | 705 Dallas Hwy 203a, Villa Rica, GA 30180-1243 |
| Yuesheng Qu | Hematology/oncology | Northwest Georgia Oncology Centers, PC | 157 Clinic Ave, Suite 101, Carrollton, GA 30117-4413 |
| Randall E Pierce | Hematology/oncology | Northwest Georgia Oncology Centers, PC | 1700 Hospital S Dr, Suite 300, Austell, GA 30106-8116 |
| Melissa D Walker | Nurse Practitioner | Northwest Georgia Oncology Centers, PC | 705 Dallas Hwy 203a, Villa Rica, GA 30180-1243 |
| David J Scholl | Physician Assistant | Northwest Georgia Oncology Centers, PC | 157 Clinic Ave, Suite 101, Carrollton, GA 30117-4413 |
| Alexandra D Tuuk | Physician Assistant | Northwest Georgia Oncology Centers, PC | 100 Market Place Blvd, Suite 200, Cartersville, GA 30121-8716 |
| Shuang Q Zhang | Hematology/oncology | Northwest Georgia Oncology Centers, PC | 2500 Hospital Blvd, Suite 140, Roswell, GA 30076-4907 |
| Curtis R Miles | Hematology/oncology | Northwest Georgia Oncology Centers, PC | 1700 Hospital S Dr, Austell, GA 30106-8116 |
| Street Address |
200 ALLEN MEMORIAL DR 302B |
| City | BREMEN |
| State | GA |
| Zip | 30110-2012 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Odessa K Spraggins | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Gaston G Foderingham | Emergency Medicine | Independence Emergency Physicians LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Michael G Hamner | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Tracey M Ragsdale | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Janice K Bain | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Alexandre F Morin | Diagnostic Radiology | Georgia West Imaging PC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Natalie M Shields | Certified Registered Nurse Anesthetist (crna) | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Alyssia N Howard | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Jeffrey R Dishman | Certified Registered Nurse Anesthetist (crna) | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Michael B Eckert | Emergency Medicine | Independence Emergency Physicians LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allison L Key | Family Medicine | 222 Gordon St, Bremen, GA 30110-1519 | |
| Steve Odeh | General Practice | 509 Alabama S Ave, Bremen, GA 30110-2007 | |
| Ralph J Templeton | Chiropractic | 507 Alabama Ave, Bremen, GA 30110-2007 | |
| Janice May Wilder | Nurse Practitioner | Bremen Family Health and Wellness | 509 Alabama S Ave, Bremen, GA 30110-2007 |
| Samuel L Ogden | Internal Medicine | 109 B Allen Memorial Dr, Bremen, GA 30110-2009 | |
| In Sook Kim | General Practice | Haralson Medical Clinic PC | 201 Allen Memorial Dr, Bremen, GA 30110-2011 |
| Pyung Kim | General Surgery | Haralson Medical Clinic PC | 201 Allen Memorial Dr, Bremen, GA 30110-2011 |
| David J Herren | Ophthalmology | Harbin Clinic LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Richard B Davis | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Quiana Scotland | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Find all physicians in zip 30110 | |||
| City | BREMEN |
| Zip Code | 30110 |
| Specialty | HEMATOLOGY/ONCOLOGY |
| City + Specialty | BREMEN + HEMATOLOGY/ONCOLOGY |
Please comment or provide details below to improve the information on Bradley J.g. Larson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.