Provider Demographics
NPI:1578730115
Name:RHODES, BRIAN BERTRAND (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:BERTRAND
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:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-0308
Mailing Address - Country:US
Mailing Address - Phone:828-322-2644
Mailing Address - Fax:828-327-2235
Practice Address - Street 1:18 13TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3748
Practice Address - Country:US
Practice Address - Phone:828-322-2644
Practice Address - Fax:828-327-2235
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD2037032085R0204X
FLME1149922085R0204X
NC2014-011822085R0202X, 2085R0204X, 2085U0001X, 2085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology