MEDICARE: KYLIE QUICK RHODES M.D.

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	207Q00000X	Family Medicine Physician	9408590	KS
2	207Q00000X	Family Medicine Physician	E-11502	AR

General Provider Information

NPI Number	:	1477932242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE QUICK RHODES M.D.

Provider Business Mailing Address
First Line	:	2603 W PLEASANT GROVE RD STE 109
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8514
Country	:	US
Telephone Number	:	479-636-4138
Fax Number	:	479-636-4140

Provider Business Practice Location Address
First Line	:	2603 W PLEASANT GROVE RD STE 109
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8514
Country	:	US
Telephone Number	:	479-636-4138
Fax Number	:

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	09/15/2020

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Directions to “ KYLIE QUICK RHODES M.D.” Practice Location

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