Healthcare Provider Details

I. General information

NPI: 1124236310
Provider Name (Legal Business Name): TERENCE RHODES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 N MAIN ST
CEDAR CITY UT
84721-9746
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 435-868-5690
  • Fax:
Mailing address:
  • Phone:
  • Fax: 304-388-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number9646639-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number24834
License Number StateWV

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3810023821
Identifier TypeMEDICAID
Identifier StateWV
Identifier Issuer
# 2
IdentifierP01087426
Identifier TypeOTHER
Identifier StateWV
Identifier IssuerRAILROAD MEDICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: