Provider Demographics
NPI:1124114509
Name:RODNEY, KANINI
Entity type:Individual
Prefix:DR
First Name:KANINI
Middle Name:
Last Name:RODNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 19TH ST S
Mailing Address - Street 2:BIRMINGHAM VA MEDICAL CENTER
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1927
Mailing Address - Country:US
Mailing Address - Phone:205-933-8101
Mailing Address - Fax:205-558-4755
Practice Address - Street 1:700 19TH ST S
Practice Address - Street 2:BIRMINGHAM VA MEDICAL CENTER
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1927
Practice Address - Country:US
Practice Address - Phone:205-933-8101
Practice Address - Fax:205-558-4755
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053025207R00000X
AL28446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine