Provider Demographics
NPI:1568490753
Name:RHODES, JEFFREY MITCHELL (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MITCHELL
Last Name:RHODES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7800 NW 85TH TER
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3385
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4050 W MEMORIAL RD FL 3
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8382
Practice Address - Country:US
Practice Address - Phone:405-608-3800
Practice Address - Fax:405-608-4768
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2140182086S0129X
OK348852086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02002528Medicaid
OKBD7C7CJEWOtherMEDICAID PIN - OK
NYP00472303OtherRAILROAD MEDICARE
OK1023087772OtherOHH PHYSICIANS GROUP NPI
OK200857710AMedicaid
OK849362OtherMEDICARE PTAN