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General NPI Number Information
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NPI Number | 1346247129
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Entity Type | Individual
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Provider Name | GEORGE H RUDWELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 12/03/2009
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Provider Practice Location Address
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Address Line | 1405 SPRING ST
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3736
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Country | US
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Telephone | 812-283-0728
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Fax | 812-283-0792
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Provider Business Mailing Address
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Address Line | 6420 DUTCHMANS PKWY 380
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City | LOUISVILLE
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State | KY
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Zip | 40205-3372
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Country | US
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Telephone | 502-894-8441
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Fax | 812-283-0792
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 01020508
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 15818
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License Number State | KY
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