Provider Demographics
NPI:1568948578
Name:KALIL, RODNEY F
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:F
Last Name:KALIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 GREEN ACRES CT
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-1106
Mailing Address - Country:US
Mailing Address - Phone:504-888-5167
Mailing Address - Fax:
Practice Address - Street 1:4812 GREEN ACRES CT
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-1106
Practice Address - Country:US
Practice Address - Phone:504-888-5167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA009637207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA009637OtherSTATE LISCENCE