Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 21438 | TN |
NPI | 1003813593 |
---|---|
Provider Name | William Rodes II |
First Address | Nashville, TN 37203-1401 |
Second Address | Nashville, TN 37203-1401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 20/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009992545 | (05) | AL |
3029941 | BCBS NUMBER (01) | TN |
3062832 | (05) | TN |
64799869 | (05) | KY |
F10880 | (02) | TN |