Provider Demographics
NPI:1598791824
Name:GALVEZ, RODRIGO M (MD)
Entity Type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:M
Last Name:GALVEZ
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3531 LAKELAND DR
Mailing Address - Street 2:COMPLEX B SUITE 1040
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-8839
Mailing Address - Country:US
Mailing Address - Phone:601-932-0973
Mailing Address - Fax:601-932-2898
Practice Address - Street 1:3531 LAKELAND DR
Practice Address - Street 2:COMPLEX B SUITE 1040
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8839
Practice Address - Country:US
Practice Address - Phone:601-932-0973
Practice Address - Fax:601-932-2898
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS075542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00017653Medicaid
D00645Medicare UPIN