Provider Demographics
NPI:1770707994
Name:RODRIGUEZ, WILLIAM JOSEPH (MA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6609 SAN ILDEFONSO DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2168
Mailing Address - Country:US
Mailing Address - Phone:505-301-7308
Mailing Address - Fax:505-890-5507
Practice Address - Street 1:2929 COORS BLVD NW
Practice Address - Street 2:SUITE 310
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1173
Practice Address - Country:US
Practice Address - Phone:505-301-7308
Practice Address - Fax:505-890-5507
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator