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General NPI Number Information
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NPI Number | 1396078895
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Entity Type | Individual
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Provider Name | JASON DAVID RODNEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN ST DEPARTMENT OF ANESTHESIOLOGY
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City | DETROIT
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State | MI
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Zip | 48201-2119
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Country | US
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Telephone | 313-745-5535
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Fax | 313-745-5448
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Provider Business Mailing Address
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Address Line | 242 THOMPSON BLVD.
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City | WINSOR
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State | ONTARIO
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Zip | N8S2G4
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Country | CA
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Telephone | 313-404-0652
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Fax | 519-254-1431
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301090682
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License Number State | MI
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