MEDICARE: JAMES HOWELL ROGERS JR. PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY001529	GA

General Provider Information

NPI Number	:	1487782413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES HOWELL ROGERS JR. PH.D.

Provider Business Mailing Address
First Line	:	41 LENOX POINTE NE
Second Line	:	SUITE A
City	:	ATLANTA
State	:	GA
Zip	:	30324-7424
Country	:	US
Telephone Number	:	404-235-9494
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 LENOX POINTE NE
Second Line	:	SUITE A
City	:	ATLANTA
State	:	GA
Zip	:	30324-7424
Country	:	US
Telephone Number	:	404-235-9494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	09/11/2008

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