Individual
JONNATHAN RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
755 DUNN RD STE 110, HAZELWOOD, MO 63042-1753
(314) 731-4222
(314) 731-4020
Mailing address
755 DUNN RD STE 110, HAZELWOOD, MO 63042-1753
(314) 731-4222
(314) 731-4020
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2017015272
MO
207R00000X
Internal Medicine Physician
Primary
2020024095
MO
Other
Enumeration date
07/25/2017
Last updated
07/21/2022
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