Healthcare Provider Details
I. General information
NPI: 1861451338
Provider Name (Legal Business Name): JOSEPH HOWARD RUPARD M D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/22/2006
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
883 UNION STREET
SHELBYVILLE TN
37160-3108
US
IV. Provider business mailing address
883 UNION ST
SHELBYVILLE TN
37160-2607
US
V. Phone/Fax
- Phone: 931-685-1145
- Fax: 931-685-8014
- Phone: 931-685-1145
- Fax: 931-685-8014
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD024783 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: