Individual
GERALD LANE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
255 W 5TH ST SW, ROME, GA 30165-2819
(706) 295-3855
(706) 235-5875
Mailing address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
025219
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000268177H
—
GA
Enumeration date
12/15/2006
Last updated
11/30/2011
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