Individual
ANTONIO R RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1831 5TH AVE, COLUMBUS, GA 31904-8915
(706) 320-8780
Mailing address
1831 5TH AVE, COLUMBUS, GA 31904-8915
(706) 320-8780
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
16484
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00019005G
—
GA
01
—
024726
BCBS GA
GA
01
—
58257864831901B001
TRICARE WPS
—
Enumeration date
11/17/2006
Last updated
07/08/2007
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