Provider Demographics
NPI:1710946280
Name:LUPARDUS, RODNEY L (MD)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:L
Last Name:LUPARDUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6810 STATE ROUTE 162 BOX 215
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-8501
Mailing Address - Country:US
Mailing Address - Phone:618-391-6405
Mailing Address - Fax:618-288-4088
Practice Address - Street 1:108 WEST US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:IL
Practice Address - Zip Code:62294
Practice Address - Country:US
Practice Address - Phone:618-391-5065
Practice Address - Fax:618-667-2779
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2020-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036085633207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine