Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD27579 | OR |
N | 207QS0010X | Family Doctor - Sports Medicine | MD27576 | OR |
NPI | 1245311661 |
---|---|
Provider Name | Dr. Barry B Rhodes |
First Address | Milwaukie, OR 97269-2075 |
Second Address | Milwaukie, OR 97222-6636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 17/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
274675 | (05) | OR |