Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Godly Obomate Jack, MD

Individual provider Cardiovascular Disease Physician · NPI 1114452588

Godly Obomate Jack, MD is an Interventional Cardiology in Cartersville, Georgia. Qualified in 2017, 9 years ago. Practices with Harbin Clinic LLC, a 254-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

150 Gentilly Blvd
Cartersville, GA 30120-8522
Phone: (470) 490-6670
Fax: (770) 382-5762
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 98756 (GA)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 98756 (GA)

Record details

NPI number1114452588
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 24, 2017
Last updated in NPPESJune 20, 2024
Certification dateJune 20, 2024
Mailing address221 Technology Pkwy Nw, Rome, GA 30165-1369

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Harbin Clinic Llc — 254 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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