=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558385708
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REGINA MARIE RHOADES D.P.M.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2006
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4913 W RENO AVE
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73127-6339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-948-4900
-----------------------------------------------------
Fax | 405-948-4933
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1125 N PORTER AVE STE 300
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73071-6443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-307-8503
-----------------------------------------------------
Fax | 405-307-0606
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 196
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------