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NPI Code Detail

MEDICARE: DR. LEONEL G. RODARTE M.D.

MEDICARE:  DR. LEONEL G. RODARTE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianNM2002-0380NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528029980
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEONEL G. RODARTE M.D.
Provider Business Mailing Address
First Line : 3885 FOOTHILLS RD
Second Line : SUITE B
City : LAS CRUCES
State : NM
Zip : 88011-4672
Country : US
Telephone Number : 575-522-5111
Fax Number : 575-522-5115
Provider Business Practice Location Address
First Line : 3885 FOOTHILLS RD
Second Line : SUITE B
City : LAS CRUCES
State : NM
Zip : 88011-4672
Country : US
Telephone Number : 575-522-5111
Fax Number : 575-522-5115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 02/27/2013

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Directions to “ DR. LEONEL G. RODARTE M.D.” Practice Location

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