Provider Demographics
NPI:1083101257
Name:ROUNTREE, BOONE GOODWIN (DO, MED)
Entity Type:Individual
Prefix:DR
First Name:BOONE
Middle Name:GOODWIN
Last Name:ROUNTREE
Suffix:
Gender:M
Credentials:DO, MED
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:28921 HIGHWAY 5
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:AL
Mailing Address - Zip Code:35188-3613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28921 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:AL
Practice Address - Zip Code:35188-3613
Practice Address - Country:US
Practice Address - Phone:205-938-9348
Practice Address - Fax:855-840-6915
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.21722084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry