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General NPI Number Information
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NPI Number | 1467640078
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Entity Type | Individual
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Provider Name | PAUL G RUDKIN AUDIOLOGIST
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Gender | Male
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 3524 E MILWAUKEE ST
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City | JANESVILLE
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State | WI
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Zip | 53546-1626
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Country | US
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Telephone | 608-756-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 3524 E MILWAUKEE ST
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City | JANESVILLE
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State | WI
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Zip | 53546-1626
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Country | US
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Telephone | 608-756-7100
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 135-156
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License Number State | WI
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