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NPI Code Detail

MEDICARE: MR. JOSEPH ANTHONY RODRIGUEZ II

MEDICARE: MR. JOSEPH ANTHONY RODRIGUEZ II
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1821521998
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH ANTHONY RODRIGUEZ II
Provider Business Mailing Address
First Line : 12765 AL HIGHWAY 169
Second Line :
City : SALEM
State : AL
Zip : 36874-2711
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6200 BRADLEY PARK DR
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-3078
Country : US
Telephone Number : 706-221-2024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2017
Last Update Date : 04/06/2017

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