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NPI Code Detail

MEDICARE: DR. RODNEY ALBERT MARCOM D.O.

MEDICARE: DR. RODNEY ALBERT MARCOM D.O.
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
1207Q00000XFamily Medicine PhysicianOS3739FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
182906OTHERFLBLUE CROSS/BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588631659
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RODNEY ALBERT MARCOM D.O.
Provider Business Mailing Address
First Line : PO BOX 746638
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6638
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 10240 SAN JOSE BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-6203
Country : US
Telephone Number : 904-262-9204
Fax Number : 904-390-7462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 12/16/2022

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