Provider Demographics
NPI:1922874502
Name:RHODES, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:RHODES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E SMOKERISE DR
Mailing Address - Street 2:VISION CENTER
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281
Mailing Address - Country:US
Mailing Address - Phone:330-336-5301
Mailing Address - Fax:330-336-5308
Practice Address - Street 1:222 E SMOKERISE DR
Practice Address - Street 2:VISION CENTER
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281
Practice Address - Country:US
Practice Address - Phone:330-336-5301
Practice Address - Fax:330-336-5308
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician