Provider Demographics
NPI:1962467969
Name:ROOKIS, PAULA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:JEAN
Last Name:ROOKIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3485 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5603
Mailing Address - Country:US
Mailing Address - Phone:205-930-0920
Mailing Address - Fax:205-445-0115
Practice Address - Street 1:3485 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-5603
Practice Address - Country:US
Practice Address - Phone:205-930-0920
Practice Address - Fax:205-445-0115
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14819208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0366100001OtherCIGNA GOVERNMENT SERVICES PTAN
AL153680Medicaid
AL511-41456OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA
AL511-41457OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA
AL154425Medicaid
AL511-41457OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA
AL102I347380Medicare PIN