MEDICARE: JEANNIE RHODES DO

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	207P00000X	Emergency Medicine Physician	P5218	TX

General Provider Information

NPI Number	:	1861451288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNIE RHODES DO

Provider Business Mailing Address
First Line	:	GLWACH, 4430 MISSOURI AVE, BOX 1267
Second Line	:	ATTN: MCXP-CCS-CR
City	:	FT. LEONARD WOOD
State	:	MO
Zip	:	65473
Country	:	US
Telephone Number	:	573-596-0417
Fax Number	:

Provider Business Practice Location Address
First Line	:	GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL
Second Line	:	4430 MISSOURI AVE
City	:	FT. LEONARD WOOD
State	:	MO
Zip	:	65473
Country	:	US
Telephone Number	:	573-596-0417
Fax Number	:

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	02/14/2023

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