Healthcare Provider Details

I. General information

NPI: 1871949081
Provider Name (Legal Business Name): ANTHONY EDWARD RUZGA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 08/10/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N DEWEY AVE
REEDSBURG WI
53959-1049
US

IV. Provider business mailing address

S860 DOLATA CT
LA VALLE WI
53941-9274
US

V. Phone/Fax

Practice location:
  • Phone: 608-524-6487
  • Fax:
Mailing address:
  • Phone: 262-744-1824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0287
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number75812-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: