MR. RODNEY EUGENE REALON


Address: 5708 Hedgemoor Dr, Raleigh, NC 27612-6322
Phone: 9196764890

MR. RODNEY EUGENE REALON (NPI# 1275557522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275557522
Entity Type Individual
Full Name MR. RODNEY EUGENE REALON
Credential MA
Practice Address 5708 Hedgemoor Dr
Raleigh
NC 27612-6322
Practice Telephone 9196764890
Mailing Telephone 9196764890
Enumeration Date 2006-07-27
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TB0200X Psychologist
Specialization: Cognitive & Behavioral
0478 NC Behavioral Health & Social Service Providers

Office Location

Street Address 5708 HEDGEMOOR DR
City RALEIGH
State NC
Zip Code 27612-6322

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Taxonomy Information

Taxonomy Code 103TB0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Cognitive & Behavioral

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

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1972860021 Laura Lee Freeman Psychologist 545 Amity Park Rd., Mt. View Correctional Institute, Spruce Pine, NC 28777 2012-04-13
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Competitor

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City RALEIGH
Zip Code 27612

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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