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General NPI Number Information
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NPI Number | 1184865172
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Entity Type | Individual
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Provider Name | JAKE JOSEPH RODI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2009
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 10656 HIGHWAY 23
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City | BELLE CHASSE
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State | LA
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Zip | 70037-4342
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Country | US
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Telephone | 504-386-9003
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Fax | 504-324-0416
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Provider Business Mailing Address
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Address Line | 13423 BLANCO ROAD PMB 136
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City | SAN ANTONIO
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State | TX
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Zip | 78216
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Country | US
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Telephone | 210-890-8840
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Fax | 210-783-9089
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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 | MD.204199
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License Number State | LA
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