Individual
MIGUEL RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
624 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2955
(870) 508-1000
(870) 424-3089
Mailing address
860 HIGHWAY 62 E STE 10, MOUNTAIN HOME, AR 72653-3200
(870) 424-3181
(870) 424-3089
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003902
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208357758
—
AR
01
—
327858YWUJ
MEDICARE
AR
Enumeration date
06/28/2013
Last updated
03/07/2020
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