Provider Demographics
NPI:1326071366
Name:BEDSOLE, RHONDA R (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:R
Last Name:BEDSOLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:RHONDA
Other - Middle Name:MICHELE
Other - Last Name:ROWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2867
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2867
Mailing Address - Country:US
Mailing Address - Phone:251-690-8894
Mailing Address - Fax:251-544-2188
Practice Address - Street 1:3810 WULFF RD E
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5256
Practice Address - Country:US
Practice Address - Phone:251-445-0582
Practice Address - Fax:251-445-0584
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026552208000000X
AL26552208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51535966OtherBLUE CROSS BLUE SHIELD
AL51535967OtherBLUE CROSS BLUE SHIELD
AL303799379Medicaid
AL303749379Medicaid
AL303729379Medicaid
AL303769379Medicaid
AL51535968OtherBLUE CROSS BLUE SHIELD
AL303709379Medicaid
AL303719379Medicaid
AL303739379Medicaid
AL011846OtherMEDICARE GROUP NUMBER
AL1063439065OtherNPI GROUP PAYEE NUMBER