Healthcare Provider Details

I. General information

NPI: 1982912606
Provider Name (Legal Business Name): LINDSAY R. RUT P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY R BURKS P.C.-C

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 N LINCOLN AVE
BELOIT KS
67420-1215
US

IV. Provider business mailing address

1005 N LINCOLN AVE
BELOIT KS
67420-1215
US

V. Phone/Fax

Practice location:
  • Phone: 785-738-2246
  • Fax: 785-738-2560
Mailing address:
  • Phone: 785-738-2246
  • Fax: 785-738-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1501407
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: