Healthcare Provider Details

I. General information

NPI: 1740241280
Provider Name (Legal Business Name): JOSEPH BREWER RHODES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 08/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3024 STADIUM BLVD
JONESBORO AR
72401-7415
US

IV. Provider business mailing address

PO BOX 1960
JONESBORO AR
72403-1960
US

V. Phone/Fax

Practice location:
  • Phone: 870-972-7000
  • Fax: 870-972-7021
Mailing address:
  • Phone: 870-934-5117
  • Fax: 870-932-3608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC-7141
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: