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1013990431
OTTO GOYCO
CUMMING, GA
NPI
1013990431
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: GA 042473)
Enumeration Date
2005-11-21
Last Update Date
2007-07-08
Business Address
-- OTTO GOYCO
900 SANDERS RD SUITE B
CUMMING, GA 30041-5960
Phone number: 770-781-8840
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Mailing Address
-- OTTO GOYCO
4074 BOGAN BLUFF LN
BUFORD, GA 30519-4501
Phone number: 678-482-6886
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