Bastidas, Rodrigo

Bastidas, Rodrigo is an individual health care provider with primary practice located at 7210 Oak Ridge Hwy , Knoxville TN 37931-2613. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bastidas, Rodrigo can be contacted via phone (865) 647-5500.

Contact Information

Primary practice address
7210 Oak Ridge Hwy Knoxville TN 37931-2613
Phone: (865) 647-5500
Fax: (865) 647-5579
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-066566 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD62777 Tennessee

Profile Details

NPI number 1255350666
LBN Legal business name Bastidas, Rodrigo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Sep 21st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255350666 NPPES
Illinois MEDICAID 036083874 2
Illinois Other 036083874

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