Individual
CARLOS RODRIGUEZ WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 10TH AVE, COLUMBUS, GA 31901-1513
(706) 571-1120
(706) 660-1603
Mailing address
PO BOX 1038, COLUMBUS, GA 31902-1038
(706) 571-1120
(706) 660-1603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00026131
AL
207Q00000X
Family Medicine Physician
Primary
046925
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009964375
—
AL
05
—
481686160B
—
GA
05
—
481686160E
—
GA
01
—
876520
BC/BS GEORGIA
GA
Enumeration date
07/20/2005
Last updated
02/24/2014
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