Provider Demographics
NPI:1417974270
Name:HALL-RHOADES, ERIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:HALL-RHOADES
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 1:103 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-1876
Mailing Address - Country:US
Mailing Address - Phone:715-232-1314
Mailing Address - Fax:715-232-2103
Practice Address - Street 1:103 1ST AVE W
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1876
Practice Address - Country:US
Practice Address - Phone:715-232-1314
Practice Address - Fax:715-232-2103
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43890-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02187819Medicaid
NYRB3403Medicare PIN
NYH02326Medicare UPIN