Provider Demographics
NPI:1538108493
Name:RODIER, SOPHIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:M
Last Name:RODIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5030 GEORGETOWN RD NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-1309
Mailing Address - Country:US
Mailing Address - Phone:423-303-2525
Mailing Address - Fax:423-303-2528
Practice Address - Street 1:5030 GEORGETOWN RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-1309
Practice Address - Country:US
Practice Address - Phone:423-303-2525
Practice Address - Fax:423-303-2528
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000038104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G90299Medicare UPIN
TN3891976Medicare PIN