MEDICARE: DR. GAGE MICHAEL RODRIGUEZ D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1278	MS

General Provider Information

NPI Number	:	1255855748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAGE MICHAEL RODRIGUEZ D.C.

Provider Business Mailing Address
First Line	:	101 W WASHINGTON ST STE C
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-2434
Country	:	US
Telephone Number	:	601-856-2383
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 W WASHINGTON ST STE C
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-2434
Country	:	US
Telephone Number	:	601-856-2383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	01/10/2023

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