Healthcare Provider Details

I. General information

NPI: 1265249767
Provider Name (Legal Business Name): RODD AKING MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10320 W MCDOWELL RD STE L
AVONDALE AZ
85392-4863
US

IV. Provider business mailing address

10320 W MCDOWELL RD STE L1238
AVONDALE AZ
85392-4877
US

V. Phone/Fax

Practice location:
  • Phone: 623-873-0112
  • Fax: 623-873-1370
Mailing address:
  • Phone: 623-873-0112
  • Fax: 623-873-1370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RODD AKING
Title or Position: OWNER
Credential: MD
Phone: 623-873-0112