Healthcare Provider Details

I. General information

NPI: 1245355114
Provider Name (Legal Business Name): KATRINA RHODES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 GENERAL PULLER HWY
SALUDA VA
23149-3112
US

IV. Provider business mailing address

PO BOX 415
SALUDA VA
23149-0415
US

V. Phone/Fax

Practice location:
  • Phone: 804-758-2381
  • Fax:
Mailing address:
  • Phone: 804-758-2381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0101251927
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: