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General NPI Number Information
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NPI Number | 1720327810
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Entity Type | Organization
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Legal Business Name | ROD TODD MD PC
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 2282 NW TROOST ST STE 103
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City | ROSEBURG
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State | OR
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Zip | 97471-6072
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Country | US
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Telephone | 541-672-0497
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Fax | 541-957-2663
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Provider Business Mailing Address
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Address Line | 2282 NW TROOST ST STE 103
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City | ROSEBURG
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State | OR
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Zip | 97471-6072
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Country | US
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Telephone | 541-672-0497
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Fax | 541-957-2663
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Authorized Official
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Title or Position | PRESIDENT
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Name | RODNEY TODD
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Credential | MD
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Telephone | 541-672-0497
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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 | MD25765
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License Number State | OR
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