Basic Information
Provider Information
NPI: 1437411675
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RODRIGUEZ-FEO
FirstName: JOHN
MiddleName:  
NamePrefix: DR.
NameSuffix: III
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 927 FRANKLIN ST SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014306
CountryCode: US
TelephoneNumber: 2565392728
FaxNumber: 2565392666
Practice Location
Address1: 927 FRANKLIN ST SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014306
CountryCode: US
TelephoneNumber: 2565392728
FaxNumber: 2565392666
Other Information
ProviderEnumerationDate: 06/13/2012
LastUpdateDate: 01/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0117X58207TNN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
207XS0117X37074ALY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine

ID Information
IDTypeStateIssuerDescription
512-1137601ALBCBSOTHER
21792105AL MEDICAID


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