Provider Demographics
NPI:1164413118
Name:RHODES, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:RHODES
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 1:6 STEPTOE CIR
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301-2500
Mailing Address - Country:US
Mailing Address - Phone:775-289-3612
Mailing Address - Fax:775-289-6423
Practice Address - Street 1:6 STEPTOE CIR
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-2500
Practice Address - Country:US
Practice Address - Phone:775-289-3612
Practice Address - Fax:775-289-6423
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11625207P00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPENDINGMedicaid
NV11625OtherNV STATE LICENSE
NVPENDINGMedicare ID - Type Unspecified
NV11625OtherNV STATE LICENSE