MEDICARE: CANON TATE ROOKER PA

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1669130852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANON TATE ROOKER PA

Provider Business Mailing Address
First Line	:	13153 OLD HICKORY BLVD APT 822
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37013-4984
Country	:	US
Telephone Number	:	912-312-2319
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 HAMMOND DR STE 400
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-8617
Country	:	US
Telephone Number	:	404-256-2633
Fax Number	:

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

Provider Enumeration Date	:	12/04/2021
Last Update Date	:	12/04/2021

Similar Medicare Providers

1043453111 — DR. NICKOLAS BERNARD REIMER MD
Practice Location Address:

1150 HAMMOND DR STE 400
SANDY SPRINGS, GA
30328-8617

Practice Phone: 770-292-6500
Practice Fax: 470-889-0704

1316470479 — WILLIAM STRAWN GODFREY M.D.
Practice Location Address:

1150 HAMMOND DR STE 400
SANDY SPRINGS, GA
30328-8617

Practice Phone: 770-762-1786
Practice Fax:

1497411235 — ERIN FRANCES HEMBREE
Practice Location Address:

1150 HAMMOND DR STE 400
SANDY SPRINGS, GA
30328-8617

Practice Phone: 404-256-2633
Practice Fax:

1639573645 — A BETTER CHOICE, LLC
Practice Location Address:

8621 SANDY PLAINS DR
RIVERVIEW, FL
33578-8617

Practice Phone: 813-368-0673
Practice Fax:

1669878294 — CONNECTIONS SERVICES
Practice Location Address:

8621 SANDY PLAINS DR
RIVERVIEW, FL
33578-8617

Practice Phone: 813-817-7333
Practice Fax: 813-672-1334

1588117972 — CONNECTING COMMUNITY HEALTHCARE
Practice Location Address:

8621 SANDY PLAINS DR
RIVERVIEW, FL
33578-8617

Practice Phone: 813-892-7811
Practice Fax:

Directions to “ CANON TATE ROOKER PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.