Healthcare Provider Details

I. General information

NPI: 1164430336
Provider Name (Legal Business Name): JAMES PLESANT RHODES II D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E. MAIN ST
DAVIS OK
73030-1775
US

IV. Provider business mailing address

502 E MAIN ST.
DAVIS OK
73030-1775
US

V. Phone/Fax

Practice location:
  • Phone: 580-369-3600
  • Fax: 580-369-3728
Mailing address:
  • Phone: 580-369-3600
  • Fax: 580-369-3728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2669
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: