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NPI Code Detail

MEDICARE: DR. WILMAR RODRIGUEZ M.D.

MEDICARE:  DR. WILMAR  RODRIGUEZ  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
1208800000XUrology Physician24390KS

General Provider Information

NPI Number : 1902895022
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILMAR RODRIGUEZ M.D.
Provider Business Mailing Address
First Line : PO BOX 847
Second Line :
City : EL DORADO
State : KS
Zip : 67042-0847
Country : US
Telephone Number : 316-321-7683
Fax Number : 316-322-7750
Provider Business Practice Location Address
First Line : 403 WOODLAND HILLS BLVD
Second Line :
City : FORT SCOTT
State : KS
Zip : 66701-8798
Country : US
Telephone Number : 620-223-8040
Fax Number : 620-223-8524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 07/08/2007

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Directions to “ DR. WILMAR RODRIGUEZ M.D.” Practice Location

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