Individual
DR. EDWIN IVAN RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
15311 W 119TH ST, OLATHE, KS 66062-5290
(913) 780-3200
(913) 780-6770
Mailing address
2800 SW WANAMAKER RD, SUITE 192, TOPEKA, KS 66614-4293
(785) 272-0707
(785) 271-1512
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KS-1466
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100220540B
—
KS
01
—
22515081
BCBS OF KC
—
01
—
3405670
AETNA
KS
01
—
390312
BCBS
—
01
—
P00327881
MEDICARE RAILROAD
KS
Enumeration date
11/15/2005
Last updated
02/24/2012
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