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General NPI Number Information
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NPI Number | 1245674118
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Entity Type | Individual
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Provider Name | RYAN RHODES M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15813 PAUL VEGA MD DR STE 201
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City | HAMMOND
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State | LA
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Zip | 70403-1431
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Country | US
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Telephone | 985-230-7440
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Fax | 985-230-7441
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Provider Business Mailing Address
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Address Line | PO BOX 2668
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City | HAMMOND
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State | LA
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Zip | 70404-2668
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Country | US
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Telephone | 985-230-7440
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Fax | 985-230-7441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | MD.207246
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.207246
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License Number State | LA
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