Rudolf, Jonathan B

Rudolf, Jonathan B is an sole proprietor health care provider with primary practice located at 801 W Maple St , Farmington NM 87401-5630. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Rudolf, Jonathan B can be contacted via phone (505) 325-5011.

Contact Information

Primary practice address
801 W Maple St Farmington NM 87401-5630
Fax: (505) 324-2259
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2004-0021 New Mexico

Profile Details

NPI number 1851366561
LBN Legal business name Rudolf, Jonathan B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 17th, 2006
Last updated Aug 20th, 2015 - about 9 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 1851366561 NPPES
New Mexico MEDICAID 97526550

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