Provider Demographics
NPI:1437166683
Name:BLAND, RODNEY L (DPM)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:L
Last Name:BLAND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 673
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851
Mailing Address - Country:US
Mailing Address - Phone:757-517-0465
Mailing Address - Fax:757-517-0575
Practice Address - Street 1:708 CLAY ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1823
Practice Address - Country:US
Practice Address - Phone:757-653-7828
Practice Address - Fax:757-517-0575
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103001047213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437166683Medicaid
VA1437166683Medicaid
U68433Medicare UPIN
VVA599F210Medicare PIN
VA480000676Medicare ID - Type Unspecified