Individual
KEVIN A RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32395
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
841173
—
AZ
01
—
P00321427
RAILROAD MEDICARE
AZ
Enumeration date
12/02/2005
Last updated
07/08/2007
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