IndividualActive
Godly Jack, MD
NPI 1114452588 · Interventional Cardiology Physician · Cartersville, GA
Provider details
- NPI number
- 1114452588
- Entity type
- Individual
- Primary specialty
- Interventional Cardiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 98756 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
150 Gentilly Blvd
Cartersville, GA 30120-8522
Phone: (470) 490-6670
Fax: (770) 382-5762
Approximate (ZIP-level) locationGet directions
Mailing address
221 Technology Pkwy Nw
Rome, GA 30165-1369
Registry dates
- Enumerated
- 2017-04-24
- Last updated
- 2024-06-20
- Certified
- 2024-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.