Provider Demographics
NPI:1942313168
Name:RHODES, JEFFREY KIRK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:KIRK
Last Name:RHODES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 9TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-4552
Mailing Address - Country:US
Mailing Address - Phone:330-830-8771
Mailing Address - Fax:
Practice Address - Street 1:1114 W HIGH ST
Practice Address - Street 2:
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-1438
Practice Address - Country:US
Practice Address - Phone:330-683-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-25964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist