Provider Demographics
NPI:1215201595
Name:DORAND, RODNEY DIXON (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:DIXON
Last Name:DORAND
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 1:530 BLUE MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5122
Mailing Address - Country:US
Mailing Address - Phone:334-399-9553
Mailing Address - Fax:850-267-0359
Practice Address - Street 1:530 BLUE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-5122
Practice Address - Country:US
Practice Address - Phone:334-399-9553
Practice Address - Fax:850-267-0359
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-03
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56208208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics