Provider Demographics
NPI:1053992909
Name:RHODES, CASSIDY (DO)
Entity type:Individual
Prefix:DR
First Name:CASSIDY
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CASSIDY
Other - Middle Name:
Other - Last Name:GOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2800 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-6523
Mailing Address - Country:US
Mailing Address - Phone:479-314-4000
Mailing Address - Fax:
Practice Address - Street 1:2800 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-6523
Practice Address - Country:US
Practice Address - Phone:479-314-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-16036207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program