Provider Demographics
NPI:1801841390
Name:RHODES, NATHAN AARON (MA CCC-A)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:AARON
Last Name:RHODES
Suffix:
Gender:M
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W HANSELL ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6649
Mailing Address - Country:US
Mailing Address - Phone:229-228-6355
Mailing Address - Fax:229-228-6841
Practice Address - Street 1:305 W HANSELL ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6649
Practice Address - Country:US
Practice Address - Phone:229-228-6355
Practice Address - Fax:229-228-6841
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003735231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00399073OtherRAILROAD MEDICARE
GA343937OtherWELLCARE
GA343937OtherWELLCARE