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Individual

RODNEY J STATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2863 HIGHWAY 45 BYP, JACKSON, TN 38305-3618
(731) 664-1375
(731) 660-2558
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-8697
(731) 422-5743

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM361
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3351673
TN
Enumeration date
03/09/2006
Last updated
11/29/2012
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