Individual
RODNEY WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPT OF OB/GYN, SHREVEPORT, LA 71103-4228
(318) 675-8700
(318) 675-8706
Mailing address
1501 KINGS HWY, DEPT OF OB/GYN, SHREVEPORT, LA 71103-4228
(318) 675-8700
(318) 675-8706
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
016388
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1350991
—
LA
Enumeration date
08/17/2006
Last updated
07/29/2009
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