Provider Demographics
NPI:1598701161
Name:WREN, RODNEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:L
Last Name:WREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:631 ELM ST SW
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1952
Mailing Address - Country:US
Mailing Address - Phone:541-812-4900
Mailing Address - Fax:541-812-4926
Practice Address - Street 1:631 ELM ST SW
Practice Address - Street 2:SUITE 204
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1952
Practice Address - Country:US
Practice Address - Phone:541-812-4900
Practice Address - Fax:541-812-4926
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2013-02-28
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Provider Licenses
StateLicense IDTaxonomies
ORMD14412207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC94121Medicare UPIN