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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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