Provider Demographics
NPI:1902271919
Name:RHODES, SCOTT WHITTEN (DPT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:WHITTEN
Last Name:RHODES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 KRISTEN CV
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6641
Mailing Address - Country:US
Mailing Address - Phone:601-672-1803
Mailing Address - Fax:
Practice Address - Street 1:108 CLINTON PKWY
Practice Address - Street 2:BAPTIST PT-CLINTON
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4730
Practice Address - Country:US
Practice Address - Phone:601-926-2018
Practice Address - Fax:601-924-9746
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3644225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07778736Medicaid
MS470696YJ5JMedicare UPIN