Healthcare Provider Details

I. General information

NPI: 1881698272
Provider Name (Legal Business Name): RICHARD H RHODES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 01/27/2020
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9025 ADMIRALS POINTE DR
INDIANAPOLIS IN
46236-9050
US

IV. Provider business mailing address

9025 ADMIRALS POINTE DR
INDIANAPOLIS IN
46236-9050
US

V. Phone/Fax

Practice location:
  • Phone: 317-823-9034
  • Fax: 317-621-5678
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number01035693A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: