Doctor Name: | LUTHER C ROLLINS III MD |
NPI Number: | 1043228364 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 023101 |
Business Practice Address: | 1140 Hammond Drive, Ne Bldg D-4190 Atlanta, GA - 30328 |
Business Phone Number: | 4043511745 |
Business Fax Number: | 4043517121 |
Mailing Address: | 1140 Hammond Drive, Ne, Bldg D-4190 ATLANTA |
State: | GA |
Postal Code: | 30328 |
Phone Number: | 7705588501 |
Fax Number: | 7705588512 |
NPI Enumeration Date: | 08/03/2006 |
NPI Last Update Date: | 09/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 023101 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |