Individual
MIGUEL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2220 W IOWA AVE, CHICKASHA, OK 73018-2738
(405) 779-2721
(405) 779-2310
Mailing address
2220 W IOWA AVE, CHICKASHA, OK 73018-2738
(405) 779-2721
(405) 779-2310
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
24730
OK
207R00000X
Internal Medicine Physician
24730
OK
208M00000X
Hospitalist Physician
Primary
24730
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200079800A
—
OK
01
—
P00684450
MCR RAILROAD PTAN
OK
Enumeration date
07/24/2006
Last updated
08/16/2016
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