Individual
JACK JOSEPH RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 JEFFERSON DAVIS BLVD, SUITE 120, NATCHEZ, MS 39120-5104
(601) 442-9210
(601) 442-7409
Mailing address
400 S COMMERCE ST, NATCHEZ, MS 39120-3506
(601) 442-9210
(601) 442-7409
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
15252
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123444
—
MS
05
—
09015568
—
MS
Enumeration date
07/15/2005
Last updated
02/01/2018
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