MEDICARE: DR. JAMES PLESANT RHODES II D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2669	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0005443695	OTHER	OK	AETNA
3	73157943900	OTHER	OK	HEALTH CHOICE

General Provider Information

NPI Number	:	1164430336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PLESANT RHODES II D.C

Provider Business Mailing Address
First Line	:	502 E MAIN ST.
Second Line	:
City	:	DAVIS
State	:	OK
Zip	:	73030-1775
Country	:	US
Telephone Number	:	580-369-3600
Fax Number	:	580-369-3728

Provider Business Practice Location Address
First Line	:	502 E. MAIN ST
Second Line	:
City	:	DAVIS
State	:	OK
Zip	:	73030-1775
Country	:	US
Telephone Number	:	580-369-3600
Fax Number	:	580-369-3728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	08/06/2020

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