Individual
A RAFAEL ROURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DWIGHT D EISENHOWER ARMY MEDICAL CENTER, FT GORDON, GA 30905
(706) 787-6158
Mailing address
35202 3RD AVE #370, FT GORDON, GA 30905
(904) 651-2888
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME72475
FL
207X00000X
Orthopaedic Surgery Physician
Primary
ME 72475
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272246100
—
FL
Enumeration date
07/04/2006
Last updated
10/04/2010
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