Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD.207246 | LA |
N | 207QS0010X | Family Doctor - Sports Medicine | MD.207246 | LA |
NPI | 1245674118 |
---|---|
Provider Name | Dr. Ryan Rhodes |
First Address | Hammond, LA 70404-2668 |
Second Address | Hammond, LA 70403-1431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2013 |
Last Update Date | 17/03/2018 |