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General NPI Number Information
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NPI Number | 1073573556
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Entity Type | Individual
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Provider Name | RODNEY ALLEN SIRK M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 341 GREENO RD N
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City | FAIRHOPE
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State | AL
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Zip | 36532-2979
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Country | US
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Telephone | 334-618-2237
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Fax |
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Provider Business Mailing Address
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Address Line | 341 GREENO RD N
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City | FAIRHOPE
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State | AL
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Zip | 36532-2979
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Country | US
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Telephone | 334-618-2237
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30273
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 30273
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License Number State | AL
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