Provider Demographics
NPI:1962409433
Name:RHEA, ROBERT EUGENE (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EUGENE
Last Name:RHEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N MAIN ST
Mailing Address - Street 2:SUITE #9
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1362
Mailing Address - Country:US
Mailing Address - Phone:615-792-8585
Mailing Address - Fax:615-792-8555
Practice Address - Street 1:202 N MAIN ST
Practice Address - Street 2:#9
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1362
Practice Address - Country:US
Practice Address - Phone:615-792-8585
Practice Address - Fax:615-792-8555
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000018217207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3144125OtherBCBS
TN3861039Medicaid
TN4004428OtherBCBS OF TN & TNCARE
TNP00274910OtherRAILROAD MEDICARE
TN621846505OtherTAX ID NUMBER
TN080170627Medicare PIN
TNA99354Medicare UPIN
TN3861039Medicaid