Provider Demographics
NPI:1104293794
Name:RHODES, JOSHUA ALAN (PA-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALAN
Last Name:RHODES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 SKYLAR DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9359
Mailing Address - Country:US
Mailing Address - Phone:304-793-2059
Mailing Address - Fax:304-793-2537
Practice Address - Street 1:157 SKYLAR DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9359
Practice Address - Country:US
Practice Address - Phone:304-793-2059
Practice Address - Fax:304-793-2537
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV690363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant