Individual
MR. JONATHAN WALRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
501 REDMOND RD NW, ROME, GA 30165-1415
(706) 291-0291
Mailing address
80 WILLOWRUN DR SW, ROME, GA 30165-8734
(859) 445-5530
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R4541
KY
207R00000X
Internal Medicine Physician
Primary
85842
GA
390200000X
Student in an Organized Health Care Education/Training Program
R4541
KY
Other
Enumeration date
03/23/2017
Last updated
01/21/2021
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