Provider Demographics
NPI:1518023282
Name:RHOADES, GEORGE F JR (PHD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:F
Last Name:RHOADES
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 1247 KAAHUMANU ST
Mailing Address - Street 2:SUITE 223
Mailing Address - City:ALEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-487-5433
Mailing Address - Fax:808-487-5444
Practice Address - Street 1:98 1247 KAAHUMANU ST
Practice Address - Street 2:SUITE 223
Practice Address - City:ALEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-487-5433
Practice Address - Fax:808-487-5444
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY281103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01275701Medicaid
HIA004OtherTRICARE
HI13482OtherHMSA
0000TCBGPMedicare UPIN
HI01275701Medicaid