Provider Demographics
NPI:1891680328
Name:RODRIGUEZ, DILLON COLE (DO)
Entity type:Individual
Prefix:DR
First Name:DILLON
Middle Name:COLE
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 HUALAPAI MOUNTAIN RD APT 315
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-8303
Mailing Address - Country:US
Mailing Address - Phone:928-542-1397
Mailing Address - Fax:
Practice Address - Street 1:3801 SANTA ROSA DR # 400
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-2311
Practice Address - Country:US
Practice Address - Phone:928-681-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR4649207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine