Individual
OSVALDO ACOSTA-RODRIGUEZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 SOUTHWEST BLVD, STE C, JEFFERSON CITY, MO 65109
(573) 632-5786
(573) 632-5833
Mailing address
1500 SOUTHWEST BLVD, STE C CAPITAL REGION CORPORATE HEALTH CLINIC, JEFFERSON CITY, MO 65109
(573) 632-5786
(573) 632-5833
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2003026609
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0549741
CIGNA
—
01
—
1178759
FIRST HEALTH
—
01
—
187895
BLUE CROSS BLUE SHIELD
—
01
—
627300
HEALTHLINK
—
01
—
CD9211
RR MEDICARE
—
01
—
G17884
MERCY
—
01
—
P00085648
RR MEDICARE
—
Enumeration date
02/09/2006
Last updated
07/08/2007
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