Organization
JIM W. RODERIQUE, M.D., P.C.
Active
Other names
The Roderique Centre for Hand and Upper Extremity Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL T. CAUDELL (ADMINISTRATOR)
(404) 872-4263
Entity
Organization
Contact information
Practice address
955 SPRING ST NW, ATLANTA, GA 30309-3821
(404) 872-4263
(404) 873-2455
Mailing address
955 SPRING ST NW, ATLANTA, GA 30309-3821
(404) 872-4263
(404) 873-2455
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55002692A
—
GA
Enumeration date
07/22/2006
Last updated
08/22/2020
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