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Contact Information

JORGE P LEGUIZAMO, MD
698 DULUTH HWY
SUITE 201
LAWRENCEVILLE, GA30045-7695
 Phone: 770-822-0788
 Fax: 770-822-0326
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JORGE P LEGUIZAMO · (Male)

NPI Number 1285612168
Status Active
Credentials MD
Entity Individual
Enumeration date 01/03/2006
Last updated 08/14/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • GA License # 061479
  • GA Medicaid 624397991D
  • GA Medicaid 624397991E
Hospital affiliation(s)
  • GWINNETT MEDICAL CENTER - (Acute Care)
    1000 MEDICAL CENTER BOULEVARD
    LAWRENCEVILLE, GA 30045
  • NORTHSIDE HOSPITAL - (Acute Care)
    1000 JOHNSON FERRY ROAD, NE
    ATLANTA, GA 30342
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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