Individual
WILSANIA L. RODRIGUEZ MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12701 PADGETT SWITCH ROAD, MEDICINE DEPT., IRVINGTON, AL 36544-4011
(251) 824-2174
(251) 824-2174
Mailing address
POST OFFICE BOX 769, BAYOU LA BATRE, AL 36509-0769
(251) 824-2174
(251) 824-2286
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31896
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140600
—
AL
01
—
511-28738
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/30/2009
Last updated
04/30/2013
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