MEDICARE: RAUSCH FAMILY PRACTICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	019757	GA

General Provider Information

NPI Number	:	1033425939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAUSCH FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	1000 WYNGATE PKWY
Second Line	:	SUITE 210
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6981
Country	:	US
Telephone Number	:	678-384-7305
Fax Number	:	770-928-9109

Provider Business Practice Location Address
First Line	:	1000 WYNGATE PKWY
Second Line	:	SUITE 210
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6981
Country	:	US
Telephone Number	:	678-384-7305
Fax Number	:	770-928-9109

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. JUDITH RAUSCH
Credential	:	M.D.
Telephone Number	:	404-444-6416

Provider Enumeration Date	:	08/30/2010
Last Update Date	:	08/30/2010

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Directions to “RAUSCH FAMILY PRACTICE ” Practice Location

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