Healthcare Provider Details

I. General information

NPI: 1902901853
Provider Name (Legal Business Name): MICHAEL PRESTON RULON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 MURPHY RD SUITE 210
MEDFORD OR
97504-4346
US

IV. Provider business mailing address

691 MURPHY RD SUITE 210
MEDFORD OR
97504-4346
US

V. Phone/Fax

Practice location:
  • Phone: 541-779-3520
  • Fax: 541-779-3702
Mailing address:
  • Phone: 541-779-3520
  • Fax: 541-779-3702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD14214
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: