Individual
DR. FREDERICK G. RODOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 E PRUDHOMME ST, OPELOUSAS, LA 70570-6490
(337) 948-6511
(337) 948-6512
Mailing address
305 E PRUDHOMME ST, OPELOUSAS, LA 70570-6490
(337) 948-6511
(337) 948-6512
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
010172
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0632240001
DURABLE MEDICAL EQUIPMENT
LA
05
—
1112071
—
LA
01
—
342009015
RAILROAD MEDICARE
LA
01
—
720700403
TAX ID
LA
Enumeration date
11/29/2005
Last updated
07/08/2007
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