Healthcare Provider Details

I. General information

NPI: 1922020106
Provider Name (Legal Business Name): LORI LEE RODRIGUEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 PARKWAY DR STE A
NATCHITOCHES LA
71457-6276
US

IV. Provider business mailing address

1385 HIGHWAY 494
NATCHITOCHES LA
71457-2826
US

V. Phone/Fax

Practice location:
  • Phone: 318-228-9411
  • Fax: 318-352-2488
Mailing address:
  • Phone: 318-228-9411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMD.022137
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number022137
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: