Provider Demographics
NPI:1750472411
Name:RODNEY, DENISE P (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:P
Last Name:RODNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2055 S LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-4727
Mailing Address - Country:US
Mailing Address - Phone:937-323-4003
Mailing Address - Fax:937-323-4023
Practice Address - Street 1:2055 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-4727
Practice Address - Country:US
Practice Address - Phone:937-323-4003
Practice Address - Fax:937-323-4023
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-073249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2246055Medicaid
OH2246055Medicaid
OHH059050Medicare PIN