Healthcare Provider Details

I. General information

NPI: 1316903537
Provider Name (Legal Business Name): JAMES A RUGOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 E LASALLE AVENUE
BARRON WI
54812
US

IV. Provider business mailing address

233 W MADISON STREET
EAU CLAIRE WI
54703
US

V. Phone/Fax

Practice location:
  • Phone: 715-832-5454
  • Fax: 715-832-2991
Mailing address:
  • Phone: 715-832-5454
  • Fax: 715-832-2991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number18024020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: