Provider Demographics
NPI:1780734863
Name:CURTIS, RODNEY LEE II (MD)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:LEE
Last Name:CURTIS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6924
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0929
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:304-233-6073
Practice Address - Street 1:51370 NATIONAL RD E
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8542
Practice Address - Country:US
Practice Address - Phone:740-695-6625
Practice Address - Fax:304-233-6073
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15668208800000X
OH35063517208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0130220000Medicaid
OH0895616Medicaid
WV0130220000Medicaid
OH0726602Medicare ID - Type Unspecified
WVF26159Medicare UPIN
WV0726604Medicare ID - Type Unspecified