MEDICARE: DR. JAMES BRIAN RUTLAND PH.D.

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	103TC0700X	Clinical Psychologist	1665	AL

General Provider Information

NPI Number	:	1558593871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES BRIAN RUTLAND PH.D.

Provider Business Mailing Address
First Line	:	UNIT 2022
Second Line	:
City	:	APO
State	:	AP
Zip	:	96264-2022
Country	:	US
Telephone Number	:	11-826-3470
Fax Number	:

Provider Business Practice Location Address
First Line	:	48TH MEDICAL GROUP/RAF LAKENHEATH
Second Line	:	UNIT 5115
City	:	APO
State	:	AL
Zip	:	09461-5115
Country	:	US
Telephone Number	:	314-226-8124
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	06/21/2026

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