Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 006704 | GA |
NPI | 1336309186 |
---|---|
Provider Name | Dr. James Roy Rowland JR. |
First Address | Dublin, GA 31021-2998 |
Second Address | Dublin, GA 31021-2998 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 10/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000606284H | (05) | GA |
30030912A | (05) | GA |
582109771 | TAX ID (01) | GA |
GRP2130 | (02) | GA |