Provider Demographics
NPI:1841436870
Name:RODRIGUEZ, RUDY RAFAEL (MD)
Entity type:Individual
Prefix:DR
First Name:RUDY
Middle Name:RAFAEL
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:201 PLAZA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5105
Mailing Address - Country:US
Mailing Address - Phone:573-472-2663
Mailing Address - Fax:573-472-2669
Practice Address - Street 1:201 PLAZA DR
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5105
Practice Address - Country:US
Practice Address - Phone:573-472-2663
Practice Address - Fax:573-472-2669
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2014-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2013026073207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery