Healthcare Provider Details

I. General information

NPI: 1205078987
Provider Name (Legal Business Name): JOHN THOMAS RUXER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 07/24/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5925 OLD HWY 60 WEST SUITE D
PADUCAH KY
42001
US

IV. Provider business mailing address

5925 OLD HWY 60
PADUCAH KY
42001
US

V. Phone/Fax

Practice location:
  • Phone: 270-228-0118
  • Fax: 270-228-0120
Mailing address:
  • Phone: 270-228-0118
  • Fax: 270-228-0120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number03360
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number03360
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: