Provider Demographics
NPI:1083659320
Name:RHOADS, JEFFERY PARKER (MD)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:PARKER
Last Name:RHOADS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7821 SW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1406
Mailing Address - Country:US
Mailing Address - Phone:785-408-5824
Mailing Address - Fax:
Practice Address - Street 1:7821 SW 12TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1406
Practice Address - Country:US
Practice Address - Phone:785-408-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-21193208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS101715OtherBCBS
KS068002110OtherMEDICARE PTAN
KS100178260CMedicaid
KS100178260DMedicaid
KS101715OtherBCBS
KS100178260CMedicaid
KS100178260DMedicaid
KS943416438OtherCOMERCIAL
KS101715Medicare ID - Type Unspecified
KS100178260DMedicaid