Carrillo, Rodolfo Bartolome

Carrillo, Rodolfo Bartolome is an individual health care provider with primary practice located at 420 Broad St Se , Gainesville GA 30501-3726. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Carrillo, Rodolfo Bartolome can be contacted via phone (770) 536-8885.

Contact Information

Primary practice address
420 Broad St Se Gainesville GA 30501-3726
Fax: (770) 536-8725
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 033243 Georgia

Profile Details

NPI number 1376633586
LBN Legal business name Carrillo, Rodolfo Bartolome
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Jul 8th, 2007 - about 17 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 1376633586 NPPES
Georgia MEDICAID 0TH000

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