Provider Demographics
NPI:1477645562
Name:RODRIGUEZ, FRED HENRY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:HENRY
Last Name:RODRIGUEZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5105 GREEN ACRES CT
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-1005
Mailing Address - Country:US
Mailing Address - Phone:504-888-8018
Mailing Address - Fax:
Practice Address - Street 1:1555 POYDRAS ST
Practice Address - Street 2:SUITE #1300
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3701
Practice Address - Country:US
Practice Address - Phone:504-556-7290
Practice Address - Fax:504-556-7350
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013267207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology