Provider Demographics
NPI:1336179431
Name:RHOADS, JONATHAN EVANS (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EVANS
Last Name:RHOADS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3S
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 120
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-851-6110
Practice Address - Fax:717-851-1999
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015227E208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA145367OtherUNISON-WMG
PA20025463OtherAMERIHEALTH MERCY-WMG
PA5446120OtherAETNA
MD621503OtherCAREFIRST MD BCBS
PA1526900OtherGATEWAY-WMG
PA175373OtherHIGHMARK BLUE SHIELD
PA106116OtherJOHNS HOPKINS
PA2117954OtherMAMSI-WMG
PA50020375OtherCAPITAL BLUE CROSS-WMG
PA0068388000OtherAMERIHEALTH 65 PA
PA36421OtherGEISINGER
PA20025463OtherAMERIHEALTH MERCY-WMG
PAP00229698Medicare PIN
C32840Medicare UPIN