Provider Demographics
NPI:1396078895
Name:RODNEY, JASON DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:DAVID
Last Name:RODNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:242 THOMPSON BLVD.
Mailing Address - Street 2:
Mailing Address - City:WINSOR
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N8S2G4
Mailing Address - Country:CA
Mailing Address - Phone:313-404-0652
Mailing Address - Fax:519-254-1431
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-745-5535
Practice Address - Fax:313-745-5448
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301090682207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology