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NPI Code Detail

MEDICARE: ERIK RODRIGUEZ

MEDICARE: ERIK RODRIGUEZ
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 Physician90881GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891258471
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIK RODRIGUEZ
Provider Business Mailing Address
First Line : 165 BLUE RIDGE OVERLOOK
Second Line :
City : BLUE RIDGE
State : GA
Zip : 30513-4431
Country : US
Telephone Number : 706-946-5607
Fax Number : 706-374-7628
Provider Business Practice Location Address
First Line : 4919 ATLANTA HWY
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-3328
Country : US
Telephone Number : 770-848-9160
Fax Number : 770-848-9161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2019
Last Update Date : 09/03/2024

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Directions to “ ERIK RODRIGUEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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