Provider Demographics
NPI:1487782413
Name:ROGERS, JAMES HOWELL JR (PHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HOWELL
Last Name:ROGERS
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:J.
Other - Middle Name:HAL
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:41 LENOX POINTE NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-7424
Mailing Address - Country:US
Mailing Address - Phone:404-235-9494
Mailing Address - Fax:
Practice Address - Street 1:41 LENOX POINTE NE
Practice Address - Street 2:SUITE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-7424
Practice Address - Country:US
Practice Address - Phone:404-235-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001529103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBFCT01Medicare UPIN