Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 07230 | AL |
Y | 111NI0900X | Internist | 07230 | AL |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 07230 | AL |
NPI | 1003971441 |
---|---|
Provider Name | Jose Rodolfo Vargas |
First Address | Birmingham, AL 35209-6808 |
Second Address | Birmingham, AL 35209-6808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 19/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000007353 | (05) | AL |
07230 | MEDICAL LICENCE (01) | AL |
AV5934446 | FEDERAL DEA (01) | |
D83860 | (02) | AL |