Individual
RODERICK O BAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 778-4760
Mailing address
6820 MORNINGSIDE DR, POPLAR BLUFF, MO 63901-8660
(573) 776-6095
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2001001459
MO
207R00000X
Internal Medicine Physician
20980
OK
207R00000X
Internal Medicine Physician
MD066618L
PA
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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