Individual
DR. CHARLES DALE RHODUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5826 NEW COPELAND RD, TYLER, TX 75703-6217
(903) 592-7200
(903) 592-7211
Mailing address
5826 NEW COPELAND RD, TYLER, TX 75703-6217
(903) 592-7200
(903) 592-7211
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1375
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046291302
—
TX
01
—
161772848
COMMERCIAL
TX
01
—
8X2110
BCBS PIN
TX
01
—
P00383164
MEDICARE RAILROAD
TX
Enumeration date
08/31/2005
Last updated
06/21/2012
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