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Individual

JONATHAN PAUL RODIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(770) 528-9938
Mailing address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(770) 528-9938

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5261
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
352355652F
GA
05
352355652G
GA
05
352355652H
GA
Enumeration date
05/14/2008
Last updated
07/08/2021
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