Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 1856111205 | UT |
N | 207RC0000X | Internist - Cardiovascular Disease | 42342 | MT |
NPI | 1003874439 |
---|---|
Provider Name | Rodney S Badger |
First Address | Palmer, AK 99645-7410 |
Second Address | Palmer, AK 99645-7410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A52735 | (02) | UT |