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General NPI Number Information
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NPI Number | 1619205754
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Entity Type | Organization
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Legal Business Name | ROCKDALE PHYSICIAN PRACTICES LLC
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 12/04/2009
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Provider Practice Location Address
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Address Line | 1301 SIGMAN RD SUITE 125
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City | CONYERS
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State | GA
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Zip | 30012-3812
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Country | US
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Telephone | 678-413-7900
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Fax | 678-413-7901
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Provider Business Mailing Address
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Address Line | 1301 SIGMAN RD SUITE 125
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City | CONYERS
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State | GA
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Zip | 30012-3812
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Country | US
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Telephone | 678-413-7900
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Fax | 678-413-7901
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DANIEL SYKES
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Credential |
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Telephone | 615-372-8505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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