| Ivan Regalado Rodriguez, | |
|
4614 Wisteria Ln, Fortson, GA 31808-6986 | |
| (770) 882-1728 | |
| Not Available |
| Full Name | Ivan Regalado Rodriguez |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 4614 Wisteria Ln, Fortson, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639871866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APRN11025390 (Florida) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN291972 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ivan Regalado Rodriguez, 4614 Wisteria Ln, Fortson, GA 31808-6986 Ph: (770) 882-1728 | Ivan Regalado Rodriguez, 4614 Wisteria Ln, Fortson, GA 31808-6986 Ph: (770) 882-1728 |
Anndrea Marie Lampkin, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4519 Ivy Patch Dr, Fortson, GA 31808 Phone: 706-681-2924 | |
Archie Person Iii, ACNPC-AG Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7933 Ivy Park Dr, Fortson, GA 31808 Phone: 706-587-0716 Fax: 706-587-0716 |