Individual
MR. PAUL L RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10166
OK
2085R0202X
Diagnostic Radiology Physician
ME90262
FL
208D00000X
General Practice Physician
04-14664
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100206250B
—
OK
01
—
248522505
MEDICARE
OK
01
—
7016639
AETNA
OK
01
—
BCBS OF KS
BCBS IND OF KS 000105163
KS
01
—
P00272804
RR MEDICARE #
OK
Enumeration date
08/05/2006
Last updated
01/27/2016
Update your record
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