Provider Demographics
NPI:1689883944
Name:TAFT, RODNEY W (MD, MTH)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:W
Last Name:TAFT
Suffix:
Gender:M
Credentials:MD, MTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:CT
Mailing Address - Zip Code:06784-0417
Mailing Address - Country:US
Mailing Address - Phone:203-788-3618
Mailing Address - Fax:
Practice Address - Street 1:94 ROUTE 39 NORTH
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:CT
Practice Address - Zip Code:06784
Practice Address - Country:US
Practice Address - Phone:203-788-3618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193553208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice