MEDICARE: DR. PHILLIP W RHOADS MD

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	2080A0000X	Pediatric Adolescent Medicine Physician	E-3188	AR
2	207R00000X	Internal Medicine Physician	E-3188	AR

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

General Provider Information

NPI Number	:	1407804503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP W RHOADS MD

Provider Business Mailing Address
First Line	:	239 W 67TH CT
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-1177
Country	:	US
Telephone Number	:	970-599-0330
Fax Number	:	970-230-6811

Provider Business Practice Location Address
First Line	:	239 W 67TH CT
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-1177
Country	:	US
Telephone Number	:	970-599-0330
Fax Number	:	970-230-6811

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	06/24/2021

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