National Provider Identifier
Rodrick Ducroix Coaxum, MD
Rodrick Ducroix Coaxum, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Elmira, NY and a listed phone number of (607) 737-4100.
Profile Overview
- NPI
- 1902436157
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- January 16, 2020
- Last Updated
- March 25, 2024
Practice Location
- 600 Roe Ave
- Elmira, NY 14905-1629
Phone: (607) 737-4100
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
- General Practice Physician (208D00000X)
Full Record
- NPI
- 1902436157
- Entity Type
- Individual
- Last Name
- Coaxum
- First Name
- Rodrick
- Middle Name
- Ducroix
- Credential
- MD
- Mailing Street Address
- 600 Roe Ave
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14905-1629
- Mailing Country
- US
- Mailing Phone
- (607) 737-4100
- Practice Street Address
- 600 Roe Ave
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14905-1629
- Practice Country
- US
- Practice Phone
- (607) 737-4100
- Enumeration Date
- January 16, 2020
- Last Updated
- March 25, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- March 25, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X), General Practice Physician (208D00000X)