Provider Demographics
NPI:1821292384
Name:JAMES A ROONEY MD PC
Entity Type:Organization
Organization Name:JAMES A ROONEY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-805-7000
Mailing Address - Street 1:799 HAMMOND DR NE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6114
Mailing Address - Country:US
Mailing Address - Phone:404-805-7000
Mailing Address - Fax:706-769-2443
Practice Address - Street 1:1582 MARS HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4836
Practice Address - Country:US
Practice Address - Phone:706-769-7546
Practice Address - Fax:706-769-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048714207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1114919438OtherINDIVIDUAL PHYSICIAN NPI
GA1114919438OtherINDIVIDUAL PHYSICIAN NPI
GA07BBSNTMedicare ID - Type Unspecified