Healthcare Provider Details

I. General information

NPI: 1639600018
Provider Name (Legal Business Name): BRYAN RHODES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 PRESTON RIDGE RD
ALPHARETTA GA
30005-3821
US

IV. Provider business mailing address

3550 PRESTON RIDGE RD
ALPHARETTA GA
30005-3821
US

V. Phone/Fax

Practice location:
  • Phone: 404-365-0966
  • Fax: 770-663-3149
Mailing address:
  • Phone: 404-365-0966
  • Fax: 770-663-3149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP60935858
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number104931
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: