Provider Information for 1669772547
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ARDELIA L RODGERS
Sex: Female
NPI: 1669772547
Last Updated: 2023-07-07
Certification Date: 2023-07-07
Certification Date: 2023-07-07
Details
Name | Value | ||||||||||||
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NPI | 1669772547 | ||||||||||||
Enumeration Date | 2010-10-26 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 10008 SUFFOLK DR LITTLE ROCK, AR 72204-4248 United States Phone: 501-412-8809 | Fax: | ||||||||||||
Primary Practice Address | 10008 SUFFOLK DR LITTLE ROCK, AR 72204-4248 United States Phone: 501-412-8809 | Fax: | ||||||||||||
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