Healthcare Provider Details

I. General information

NPI: 1285802199
Provider Name (Legal Business Name): MICHAEL BRIAN ROUNTREE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CHARLIE MORRIS RD
COLBERT GA
30628-2445
US

IV. Provider business mailing address

350 FAR VIEW DR
ESTES PARK CO
80517-9047
US

V. Phone/Fax

Practice location:
  • Phone: 706-788-2127
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number48385
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: