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NPI Code Detail

MEDICARE: A RAFAEL ROURE MD

MEDICARE: A RAFAEL ROURE MD
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
1207X00000XOrthopaedic Surgery PhysicianME 72475FL
2174400000XSpecialistME72475FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780614578
Entity Type Code : Individual
Provider Name (Legal Business Name) : A RAFAEL ROURE MD
Provider Business Mailing Address
First Line : 35202 3RD AVE #370
Second Line :
City : FT GORDON
State : GA
Zip : 30905
Country : US
Telephone Number : 904-651-2888
Fax Number :
Provider Business Practice Location Address
First Line : DWIGHT D EISENHOWER ARMY MEDICAL CENTER
Second Line :
City : FT GORDON
State : GA
Zip : 30905
Country : US
Telephone Number : 706-787-6158
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 10/04/2010

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Directions to “ A RAFAEL ROURE MD” Practice Location

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