Provider Demographics
NPI:1295962165
Name:RODRIGUE, ANNE E (DO)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:RODRIGUE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:E
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 5478
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-5478
Mailing Address - Country:US
Mailing Address - Phone:985-448-1216
Mailing Address - Fax:985-446-8765
Practice Address - Street 1:506 N ACADIA RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301
Practice Address - Country:US
Practice Address - Phone:985-448-1216
Practice Address - Fax:985-446-8765
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
LADO.000210207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1945277Medicaid
LA288944YP05Medicare PIN