| Dr Manuel Rodriguez Iv, DO | |
|
1338 Phay Ave Bldg D, Canon City, CO 81212-2326 | |
| (719) 285-2735 | |
| (719) 285-2915 |
| Full Name | Dr Manuel Rodriguez Iv |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 1338 Phay Ave Bldg D, Canon City, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326301474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | DR.0072273 (Colorado) | Primary |
| 207V00000X | Obstetrics & Gynecology | 02004519A (Indiana) | Secondary |
| Entity Name | Peak Vista Community Health Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730166034 PECOS PAC ID: 4688583974 Enrollment ID: O20031110000337 |
| Entity Name | Questcare Obstetrics Colorado Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417295932 PECOS PAC ID: 3072759133 Enrollment ID: O20130415000372 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Manuel Rodriguez Iv, DO 1338 Phay Ave Bldg D, Canon City, CO 81212-2326 Ph: () - | Dr Manuel Rodriguez Iv, DO 1338 Phay Ave Bldg D, Canon City, CO 81212-2326 Ph: (719) 285-2735 |
Mollie T Miller, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1339 Phay Ave, Canon City, CO 81212 Phone: 719-285-2700 Fax: 719-285-2455 | |
Dr. John Sloan Heavrin I, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1335 Phay Ave Ste B, Canon City, CO 81212 Phone: 719-285-2735 Fax: 719-285-2915 |