DR. JORGE PEDRO LEGUIZAMO (NPI# 1285612168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285612168 |
| Entity Type | Individual |
| Full Name | DR. JORGE PEDRO LEGUIZAMO |
| Credential | M.D. |
| Practice Address |
698 Duluth Hwy Suite 201 Lawrenceville GA 30045-7695 |
| Mailing Address |
1835 Savoy Dr Suite 300 Atlanta GA 30341-1072 |
| Practice Telephone | 7708220788 |
| Practice Fax Number | 7708220326 |
| Mailing Telephone | 7708220788 |
| Mailing Fax Number | 7708220326 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2020-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
061479 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 624397991E | 05 | |
| GA | 624397991D | 05 |
| Street Address |
698 DULUTH HWY SUITE 201 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-7695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548244817 | Gary Stillwagon | Specialist | 698 Duluth Hwy, Suite 100, Lawrenceville, GA 30046-7645 | 2005-12-01 |
| 1003363276 | Gary Partlow | Pharmacist | 698 Duluth Hwy, Lawrenceville, GA 30046-7645 | 2016-09-06 |
| 1164845285 | Doris J. Williams | Social Worker | 698 Duluth Hwy, Suite 201, Lawrenceville, GA 30046-7645 | 2014-01-24 |
| 1366872178 | Claudia M. Warren-wheat | Social Worker | 698 Duluth Hwy, Suite 201, Lawrenceville, GA 30046-7645 | 2013-11-14 |
| 1386995454 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 698 Duluth Hwy, Suite 201, Lawrenceville, GA 30046-7645 | 2012-09-28 |
| 1568627677 | Vantage Radiation Oncology Associates LLC | Radiology | 698 Duluth Hwy, Suite 100, Lawrenceville, GA 30046-7645 | 2008-07-29 |
| 1922013648 | Georgia Cancer Specialists I PC | Internal Medicine | 698 Duluth Hwy, Suite 201, Lawrenceville, GA 30045-7695 | 2006-07-30 |
| 1790739357 | Aoa Gwinnett Operating Company | Specialist | 698 Duluth Hwy, Lawrenceville, GA 30046 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821240920 | Shodeinde Ariyo Coker | Internal Medicine | 3401 Princeton Pike, Lawrenceville, NJ 08648-1205 | 2008-10-21 |
| 1659571941 | Kathleen Laveaux | Internal Medicine | 698 Duluth Hwy Ste 201, Lawrenceville, GA 30046-7648 | 2007-07-24 |
| 1649229683 | Aldemar Montero | Internal Medicine | 631 Professional Dr Ste 450, Suite 210, Lawrenceville, GA 30046-3370 | 2006-05-08 |
| 1467687566 | Ramandeep Kaur Bambrah | Internal Medicine | 631 Professional Dr Ste 450, Lawrenceville, GA 30046-3370 | 2009-05-19 |
| 1023226081 | Praveen Sivakumaran | Internal Medicine | 631 Professional Dr Ste 450, Lawrenceville, GA 30046-3370 | 2007-05-21 |
| 1912034471 | I-wen Chang | Internal Medicine | 631 Professional Dr Ste 450, Lawrenceville, GA 30046-3370 | 2007-02-28 |
| 1508926759 | Suburban Hematology Oncology Associates, PC | Internal Medicine | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 | 2006-12-11 |
| 1659460244 | Christopher T Hagenstad | Internal Medicine | 631 Professional Drive, Ste 210, Lawrenceville, GA 30046 | 2006-10-12 |
| 1821187436 | Anthony M Landis | Internal Medicine | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 | 2006-10-12 |
| 1073602751 | Alexander Saker Jr. | Internal Medicine | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046 | 2006-10-12 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.