Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 18001665B | IN |
NPI | 1265407472 |
---|---|
Provider Name | Dr. Gail Ziegler Rhoades |
First Address | Indianapolis, IN 46240-6859 |
Second Address | Indianapolis, IN 46240-6859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 13/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
410017624 | RAILROAD MEDICARE (01) | GA |
T35042 | (02) | IN |