Individual
DR. MITCHELL LEE RODEHEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1112 E ASCENSION COMPLEX BLVD, GONZALES, LA 70737-4265
(225) 450-1016
(225) 450-1150
Mailing address
1112 E ASCENSION COMPLEX BLVD # A, GONZALES, LA 70737-4265
(225) 450-1016
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
331055
LA
390200000X
Student in an Organized Health Care Education/Training Program
322824
LA
Other
Enumeration date
03/24/2020
Last updated
06/17/2024
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