Jack Rusley
MD | Pediatric Adolescent Medicine | Male
Jack Rusley, MD is a Providence, Rhode Island based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Jack Rusley is
1 Hoppin St Ste 305, Providence, Rhode Island - 02903-4141. He can be contacted on phone at
401-444-5980 and fax number 401-444-3873.
Jack Rusley is a sole proprietor of his business.
NPI number (Unique professional ID) for Jack Rusley is
1639499395 which was assigned by NPPES on 04 Jun, 2010 and it was last updated on 21 Jul, 2022.
Jack Rusley license number is
MD15912 for Pediatrics Adolescent Medicine (2080A0000X) in Rhode Island.
Jack Rusley specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Jack Rusley basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Jack Rusley |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Jack Rusley address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1 Hoppin St Ste 305
Providence, RI, 02903-4141
United States |
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| Phone Number : | 401-444-5980 |
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| Fax Number : | 401-444-3873 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1639499395 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 04 Jun, 2010 |
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| Last Updated On : | 21 Jul, 2022 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jack Rusley are as mentioned. Primary taxonomy code for Jack Rusley, MD is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080A0000X | Pediatrics Adolescent Medicine | Yes | MD15912 | RI |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
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593 EDDY ST,
PROVIDENCE, RI, 02903-4923
United States | PROVIDENCE, RI | 401-444-4712 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 593 Eddy St
Providence, RI, 02903-4923
United States |
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| Phone Number : | 401-444-4712 |
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| Fax Number : | 401-444-6220 |
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Business Location:
Patients can refer following map for directions to
Jack Rusley practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.