Reustle, Phillip Brent

Reustle, Phillip Brent is an individual health care provider with primary practice located at 225 E Wood St , Spartanburg SC 29303-3050. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Reustle, Phillip Brent can be contacted via phone (864) 560-4420.

Contact Information

Primary practice address
225 E Wood St Spartanburg SC 29303-3050
Phone: (864) 560-4420
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3367 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 3367 South Carolina

Profile Details

NPI number 1356537161
LBN Legal business name Reustle, Phillip Brent
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2007
Last updated Apr 18th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356537161 NPPES
South Carolina Other SCG4005019 MEDICARE PIN
South Carolina MEDICAID 3359PA MEDICARE PIN

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