Provider Demographics
NPI:1902973217
Name:RHODES, JARED CLINTON (MS PT)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:CLINTON
Last Name:RHODES
Suffix:
Gender:M
Credentials:MS PT
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Mailing Address - Street 1:215 N NEWTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-5421
Mailing Address - Country:US
Mailing Address - Phone:870-863-5100
Mailing Address - Fax:870-863-5102
Practice Address - Street 1:215 N NEWTON AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-5421
Practice Address - Country:US
Practice Address - Phone:870-863-5100
Practice Address - Fax:870-863-5102
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2019-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARPT2026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR133180721Medicaid
AR5T750OtherBLUE CROSS BLUE SHIELD
ARPOO149211OtherMEDICARE RAILROAD