Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 048714 | GA |
N | 207ND0101X | MOHS-Micrographic Surgeon | 048714 | GA |
N | 207NS0135X | Procedural Dermatology | 048714 | GA |
NPI | 1114919438 |
---|---|
Provider Name | James A. Rooney |
First Address | Atlanta, GA 30328-6114 |
Second Address | Albany, GA 31707-0222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 23/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G54034 | (02) | GA |