MEDICARE: K RHODES OD PLLC

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1861118408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K RHODES OD PLLC

Provider Business Mailing Address
First Line	:	PO BOX 72802
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-1031
Country	:	US
Telephone Number	:	541-390-9667
Fax Number	:

Provider Business Practice Location Address
First Line	:	29605 N CAVE CREEK RD STE 102
Second Line	:
City	:	CAVE CREEK
State	:	AZ
Zip	:	85331-2360
Country	:	US
Telephone Number	:	541-390-9667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KRISTI LYN RHODES
Credential	:	OD
Telephone Number	:	541-390-9667

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	10/14/2022

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