Provider Demographics
NPI:1437472511
Name:ROCKDALE PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:ROCKDALE PHYSICIAN PRACTICES LLC
Other - Org Name:ESSENTIAL FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:N
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8508
Mailing Address - Street 1:1775 PARKER RD SE
Mailing Address - Street 2:SUITE C240
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6654
Mailing Address - Country:US
Mailing Address - Phone:678-609-6282
Mailing Address - Fax:678-609-6283
Practice Address - Street 1:1775 PARKER RD SE
Practice Address - Street 2:SUITE C240
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6654
Practice Address - Country:US
Practice Address - Phone:678-609-6282
Practice Address - Fax:678-609-6283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty