Provider Demographics
NPI:1447221577
Name:RODGERS, TANIA ALBELDA (MD)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:ALBELDA
Last Name:RODGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 W PEORIA AVE
Mailing Address - Street 2:SUITE C500
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4608
Mailing Address - Country:US
Mailing Address - Phone:602-439-1200
Mailing Address - Fax:602-439-1234
Practice Address - Street 1:3201 W PEORIA AVE
Practice Address - Street 2:SUITE C500
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4608
Practice Address - Country:US
Practice Address - Phone:602-439-1200
Practice Address - Fax:602-439-1234
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31762207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ112475Medicare PIN