Provider Demographics
NPI:1861538035
Name:RHODES, KELLY KATHLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:KATHLEEN
Last Name:RHODES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1623 HOSPITAL LOOP
Mailing Address - Street 2:PO BOX 130
Mailing Address - City:OWYHEE
Mailing Address - State:NV
Mailing Address - Zip Code:89832
Mailing Address - Country:US
Mailing Address - Phone:775-757-2415
Mailing Address - Fax:775-757-2419
Practice Address - Street 1:1623 HOSPITAL LOOP
Practice Address - Street 2:
Practice Address - City:OWYHEE
Practice Address - State:NV
Practice Address - Zip Code:89832-1200
Practice Address - Country:US
Practice Address - Phone:775-757-2415
Practice Address - Fax:775-757-2419
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066207208D00000X
VA0116021690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine