Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 27491 | WI |
NPI | 1063484202 |
---|---|
Provider Name | Barry J Rhodes |
First Address | Eau Claire, WI 54702-1510 |
Second Address | Eau Claire, WI 54701-6101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 16/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30732100 | (05) | WI |
B56021 | (02) |