Gautam Jagoo
Medical Specialty
Professional ID
- NPI: 1124092986
- PECOS ID: 9133150600
- Enrollment ID: I20050824000612
- Credential(MD, DO, DPM): MD
- Medical School: Tufts University School Of Medicine
- Medical School Graduation Year: 1999
Hospital Service
- Hospital CCN1: 110192
- Business Name (LBN)1: Eastside Medical Center
- Hospital CCN2: 110087
- Business Name (LBN)2: Gwinnett Medical Center
Medical Practices
- Organization Name: South Gwinnett Radiology Pc
- Group Practice ID assigned by PECOS: 5496710493
- Number of Group Practice member: 11
Location
- Address1: 1700 Medical Way
- Address2:
- City: Snellville
- State: Georgia
- Zip Code: 30078
- Phone Number: (770)979-0200
Location
- Address1: 1700 Tree Ln
- Address2: Suite 100
- City: Snellville
- State: Georgia
- Zip Code: 30078
- Phone Number: (770)779-2184
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS):
- Used Electronic health record (EHR):