Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 065819 | GA |
N | 207QS0010X | Family Doctor - Sports Medicine | 065819 | GA |
NPI | 1154510410 |
---|---|
Provider Name | Catherine Michelle Strickland |
First Address | Rome, GA 30161-3224 |
Second Address | Rome, GA 30165-4290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 26/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003115285R | (05) | GA |