Provider Demographics
NPI:1740450113
Name:SPIRES, ROCHELE H (PA)
Entity type:Individual
Prefix:MISS
First Name:ROCHELE
Middle Name:H
Last Name:SPIRES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1699
Mailing Address - Country:US
Mailing Address - Phone:404-851-2300
Mailing Address - Fax:
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1699
Practice Address - Country:US
Practice Address - Phone:404-851-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-00438363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ091590Medicaid