Doctor Name: | TOMMIE RODGERS |
NPI Number: | 1558749630 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 210 Shady Oak St Saraland, AL - 365719432 |
Business Phone Number: | 2517678927 |
Business Fax Number: | |
Mailing Address: | 210 Shady Oak St, SARALAND |
State: | AL |
Postal Code: | 365719432 |
Phone Number: | 2517678927 |
Fax Number: | |
NPI Enumeration Date: | 05/11/2015 |
NPI Last Update Date: | 05/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |