Provider Demographics
NPI:1104982008
Name:RHODES, DONALD WAYNE JR (DC, PHD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WAYNE
Last Name:RHODES
Suffix:JR
Gender:M
Credentials:DC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 LURLEEN B WALLACE BLVD S
Mailing Address - Street 2:SUITE A
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2219
Mailing Address - Country:US
Mailing Address - Phone:205-345-3452
Mailing Address - Fax:
Practice Address - Street 1:1040 LURLEEN B WALLACE BLVD S
Practice Address - Street 2:SUITE A
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2219
Practice Address - Country:US
Practice Address - Phone:205-345-3452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000071047Medicare ID - Type Unspecified
T68553Medicare UPIN