Individual
JORGE O RODRIGUEZ
Active
Individual
JORGE O RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0096-01707
NC
207Q00000X
Family Medicine Physician
E-5890
AR
207QS0010X
Sports Medicine (Family Medicine) Physician
0096-01707
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
63947
GA
207QS0010X
Sports Medicine (Family Medicine) Physician
E-5890
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1021W
BCBS
NC
05
—
174644003
—
AR
Enumeration date
06/01/2006
Last updated
09/26/2019
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