Provider Demographics
NPI:1083681274
Name:RODRIGUEZ-FEO, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:RODRIGUEZ-FEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1212
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533-1212
Mailing Address - Country:US
Mailing Address - Phone:251-928-4033
Mailing Address - Fax:251-928-4032
Practice Address - Street 1:912 PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-2952
Practice Address - Country:US
Practice Address - Phone:251-928-4033
Practice Address - Fax:251-928-4032
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11349207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0542830001OtherMEDICARE PGB-DME
AL510-88164OtherBCBS
AL529400020Medicaid
AL529400020Medicaid
AL000088164Medicare PIN