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DR. RODDY PAUL INGRAHAM M.D.

Adolescent Medicine >> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1760530133

Individual Registrant:
DR. RODDY PAUL INGRAHAM M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
2971 HURRICANE RD  ROCKY FACE, GA 30740-8716 US
Tel: 706-673-7889  Fax: 706-673-3628

Contact information for business:
2971 HURRICANE RD  ROCKY FACE, GA 30740-8716 US
Tel: 706-673-7889  Fax: 706-673-3628

Registration Information:
NPI: 1760530133
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
X2080A0000XAllopathic & Osteopathic Physicians
Pediatrics
Adolescent Medicine
GA13979
X2080P0006XAllopathic & Osteopathic Physicians
Pediatrics
GA13979

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PHYSICIAN IDENTIFICATION00006982CGA01




HEALTH CARE JOBS GA - Page 1



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