Provider Demographics
NPI:1861191058
Name:FAISON, RODNEY FRANKLIN
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:FRANKLIN
Last Name:FAISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7652 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-4411
Mailing Address - Country:US
Mailing Address - Phone:954-905-0094
Mailing Address - Fax:
Practice Address - Street 1:7652 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-4411
Practice Address - Country:US
Practice Address - Phone:954-905-0094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty