Rodriguez, Etienne Jose
Rodriguez, Etienne Jose is an individual health care provider with primary practice located at 5471 Chamblee Dunwoody Rd , Dunwoody GA 30338-4114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rodriguez, Etienne Jose can be contacted via phone (770) 481-0889.Contact Information
Primary practice address
5471 Chamblee Dunwoody Rd
Dunwoody GA 30338-4114
Phone: (770) 481-0889
Fax: (770) 481-0986
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 81672 | South Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2018-02700 | North Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C159178 | California |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101265867 | Virginia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 067979 | Georgia |
Profile Details
| NPI number | 1679709539 |
|---|---|
| LBN Legal business name | Rodriguez, Etienne Jose |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2009 |
| Last updated | Sep 13th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679709539 | NPPES |
| Georgia | MEDICAID | 003125394B | |
| Georgia | MEDICAID | 003125394A | |
| Georgia | MEDICAID | 003125394C | |
| Georgia | MEDICAID | GA1345 |
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