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DR. ETIENNE JOSE RODRIGUEZ M.D. NPI 1679709539


NPI Information

NPI: 1679709539
Provider Name: DR. ETIENNE JOSE RODRIGUEZ, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
5471 CHAMBLEE DUNWOODY RD
DUNWOODY, GA
ZIP 30338
Phone: (770) 481-0889
Get Directions

DR. Etienne Jose Rodriguez, M.D. is a family medicine in Dunwoody, GA with 17 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Etienne Jose Rodriguez, M.D. NPI is 1679709539. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PONCE SCHOOL OF MEDICINE
Graduation Year:2007

The provider's business location address is:

5471 CHAMBLEE DUNWOODY RD
DUNWOODY, GA
ZIP 30338-114
Phone: (770) 481-0889
Fax: (770) 481-0986

The NPI 1679709539 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/5/2009 and was last updated on 9/13/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine81672SOUTH CAROLINANo
2207Q00000XFamily Medicine2018-02700NORTH CAROLINANo
3207Q00000XFamily MedicineC159178CALIFORNIANo
4207Q00000XFamily Medicine0101265867VIRGINIANo
5207Q00000XFamily Medicine067979GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003125394BMEDICAIDGEORGIA
2003125394AMEDICAIDGEORGIA
3003125394CMEDICAIDGEORGIA
4GA1345MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.