Basic Information
| Provider Information | |||||||||
| NPI: | 1598745598 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | HUBERT | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 661495 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352661495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059795882 | ||||||||
| FaxNumber: | 2059791248 | ||||||||
| Practice Location | |||||||||
| Address1: | 1440 HIGHWAY DR | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | AL | ||||||||
| PostalCode: | 362031951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562412230 | ||||||||
| FaxNumber: | 2562412235 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 05/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD27178 | OR | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 00022035 | AL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | P00446913 | 01 | OR | RR MEDICARE | OTHER | 8492779 | 05 | WA | MEDICAID | 274576 | 05 | OR | MEDICAID |