MEDICARE: JONATHAN RACKI MD

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	208M00000X	Hospitalist Physician	110624	GA
2	207R00000X	Internal Medicine Physician	110624	GA

General Provider Information

NPI Number	:	1306549704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN RACKI MD

Provider Business Mailing Address
First Line	:	501 REDMOND RD NW
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30165-1415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 REDMOND RD NW
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30165-1415
Country	:	US
Telephone Number	:	201-885-6571
Fax Number	:

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

Provider Enumeration Date	:	03/24/2023
Last Update Date	:	05/06/2026

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Directions to “ JONATHAN RACKI MD” Practice Location

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