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General NPI Number Information
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NPI Number | 1568994341
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Entity Type | Individual
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Provider Name | ROOP K DUTTA MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 2470 DANIELLS BRIDGE RD STE 251
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City | ATHENS
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State | GA
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Zip | 30606-6192
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Country | US
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Telephone | 706-389-3440
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Fax | 706-353-2205
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Provider Business Mailing Address
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Address Line | PO BOX 48089
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City | ATHENS
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State | GA
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Zip | 30604-8089
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Country | US
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Telephone | 706-389-3740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 103446
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License Number State | GA
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