Individual
DR. JAYSON DIVINO RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5069
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
301146
LA
2084N0400X
Neurology Physician
LL32639
SC
Other
Enumeration date
06/14/2010
Last updated
08/23/2024
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