Provider Demographics
NPI:1538261714
Name:MACE, RHONDA D (MD)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:D
Last Name:MACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 SAINT MARYS RD
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-4176
Mailing Address - Country:US
Mailing Address - Phone:785-762-2585
Mailing Address - Fax:
Practice Address - Street 1:1110 SAINT MARYS RD
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-4176
Practice Address - Country:US
Practice Address - Phone:785-762-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0426197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100190650BMedicaid
KS462809OtherFAMILY HEALTH PARTNERS
KS105330OtherBLUE CROSS BLUE SHIELD
KS106173OtherBCBS PC GRP
KSG29563Medicare UPIN
KS014060Medicare PIN