Rudisill, Douglas

Rudisill, Douglas is an sole proprietor health care provider with primary practice located at 801 E Wheeler Rd , Moses Lake WA 98837-1820. He recently has 2 registered licenses in different health care specialties including Emergency Medical Service Providers / Personal Emergency Response Attendant, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Rudisill, Douglas can be contacted via phone (509) 765-5606.

Contact Information

Primary practice address
801 E Wheeler Rd Moses Lake WA 98837-1820
Phone: (509) 765-5606
Fax: (253) 838-6418
Website:
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Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X C42852 California
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD60041375 Washington

Profile Details

NPI number 1871578740
LBN Legal business name Rudisill, Douglas
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2005
Last updated Aug 18th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871578740 NPPES
Washington Other 9111RU BSWA
Washington Other 0243670 BSWA
Washington Other 0243670 BSWA
Washington MEDICAID 8531188 BSWA

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