Courson, Rodney Glen

Courson, Rodney Glen is an sole proprietor health care provider with primary practice located at 3880 Stockton Hill Rd Ste 103128 , Kingman AZ 86409-0595. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Courson, Rodney Glen can be contacted via phone (928) 279-1387.

Contact Information

Primary practice address
3880 Stockton Hill Rd Ste 103128 Kingman AZ 86409-0595
Phone: (928) 279-1387
Fax: (928) 757-7272
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 30616 Arizona

Profile Details

NPI number 1053411769
LBN Legal business name Courson, Rodney Glen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 23rd, 2006
Last updated Feb 28th, 2012 - about 13 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 1053411769 NPPES
Arizona MEDICAID 726044

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