Provider Demographics
NPI:1811993157
Name:RHOADS, BART V (DC)
Entity type:Individual
Prefix:
First Name:BART
Middle Name:V
Last Name:RHOADS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 SOUTHWEST BLVD
Mailing Address - Street 2:STE H
Mailing Address - City:JEFFERSON CTY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-5014
Mailing Address - Country:US
Mailing Address - Phone:573-636-9977
Mailing Address - Fax:573-636-2209
Practice Address - Street 1:915 SOUTHWEST BLVD
Practice Address - Street 2:STE H
Practice Address - City:JEFFERSON CTY
Practice Address - State:MO
Practice Address - Zip Code:65109-5014
Practice Address - Country:US
Practice Address - Phone:573-636-9977
Practice Address - Fax:573-636-2209
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE005898111N00000X
TX5478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO32115Medicare ID - Type Unspecified
MO3014Medicare UPIN
MO2001094Medicare UPIN
MOU32115Medicare UPIN
MO44-01158Medicare UPIN