Provider Demographics
NPI:1245239441
Name:RHOAD, ROBERT CLARK (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLARK
Last Name:RHOAD
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 1:560 S LOOP RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3405
Mailing Address - Country:US
Mailing Address - Phone:859-301-2663
Mailing Address - Fax:859-817-7848
Practice Address - Street 1:6620 CLOUGH PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-4053
Practice Address - Country:US
Practice Address - Phone:513-232-2663
Practice Address - Fax:859-817-7848
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076021207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64023864Medicaid
OH2133319Medicaid
OH1212878001OtherCIGNA
OH2133319Medicaid
OH000000039111OtherANTHEM
OH000000214361OtherANTHEM
G92746Medicare UPIN
OH0225920002Medicare NSC
OHRH0873121Medicare PIN