=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417974270
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN HALL-RHOADES MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2006
-----------------------------------------------------
Last Update Date | 10/29/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 103 1ST AVE W
-----------------------------------------------------
City | MENOMONIE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54751-1876
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-232-1314
-----------------------------------------------------
Fax | 715-232-2103
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 103 1ST AVE W
-----------------------------------------------------
City | MENOMONIE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54751-1876
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-232-1314
-----------------------------------------------------
Fax | 715-232-2103
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 43890-20
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------