Provider Demographics
NPI:1316258171
Name:RHODES, JOHN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:RHODES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 15645
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89114-5645
Mailing Address - Country:US
Mailing Address - Phone:702-560-2886
Mailing Address - Fax:702-560-2928
Practice Address - Street 1:10105 BANBURRY CROSS DR STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6647
Practice Address - Country:US
Practice Address - Phone:702-243-8500
Practice Address - Fax:702-560-2928
Is Sole Proprietor?:No
Enumeration Date:2010-06-27
Last Update Date:2015-04-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV6286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1316258171OtherNPI
NV207Q00000XOtherTAXONOMY
NV1316258171Medicaid
NV6286OtherNV STATE LICENSE
NVV106927Medicare PIN