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JIM W. RODERIQUE M.D. P.C. NPI 1619998721


NPI Information

NPI: 1619998721
Provider Name: JIM W. RODERIQUE, M.D., P.C.

Doing Business As: THE RODERIQUE CENTRE FOR HAND AND UPPER EXTREMITY SURGERY

Classification: Orthopaedic Surgery - 207XS0106X
Entity Type: Organization

Specialization: Hand Surgery

Address:
955 SPRING ST NW
ATLANTA, GA
ZIP 30309
Phone: (404) 872-4263
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JIM W. RODERIQUE, M.D., P.C. is a hand surgery orthopaedic surgery in Atlanta, GA. The provider is an orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. JIM W. RODERIQUE, M.D., P.C. NPI is 1619998721. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As The Roderique Centre For Hand And Upper Extremity Surgery.

The provider's business location address is:

955 SPRING ST NW
ATLANTA, GA
ZIP 30309-821
Phone: (404) 872-4263
Fax: (404) 873-2455

The provider's authorized official is Carol T. Caudell .
The authorized official title is Administrator and has the following contact phone number (404) 872-4263.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XS0106XOrthopaedic SurgeryHand SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
155002692AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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