Provider Demographics
NPI:1235177338
Name:EUBANKS, RHONDA J (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:J
Last Name:EUBANKS
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 1:250 N SHADELAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 S 7TH ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1038
Practice Address - Country:US
Practice Address - Phone:812-885-3770
Practice Address - Fax:812-885-3769
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY53001207R00000X
IN01042768A207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000237944OtherANTHEM PROVIDER #
IN110174893OtherINDIVIDUAL RRAILROAD MCR#
IN100180890GMedicaid
INCH6490OtherGRP RAILROAD MEDICARE#
IN200098920Medicaid
INCH6490OtherGRP RAILROAD MEDICARE#
IN940280Medicare ID - Type UnspecifiedIN MEDICARE GROUP#
INF99868Medicare UPIN
IN100180890GMedicaid