Provider Demographics
NPI:1831573294
Name:PEREZ-RODRIGUEZ, AUDRIK L (MD)
Entity type:Individual
Prefix:
First Name:AUDRIK
Middle Name:L
Last Name:PEREZ-RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5659
Mailing Address - Country:US
Mailing Address - Phone:620-272-2579
Mailing Address - Fax:620-272-2685
Practice Address - Street 1:410 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5659
Practice Address - Country:US
Practice Address - Phone:620-272-2579
Practice Address - Fax:620-272-2685
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-46375207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology