Rudolph, Laurel A

Rudolph, Laurel A is an individual health care provider with primary practice located at 1000 N Oak Ave , Marshfield WI 54449-5703. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Rudolph, Laurel A can be contacted via phone (715) 387-5511.

Contact Information

Primary practice address
1000 N Oak Ave Marshfield WI 54449-5703
Phone: (715) 387-5511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 30492 Wisconsin
Allopathic & Osteopathic Physicians / Sports Medicine 207RS0010X 30492 Wisconsin

Profile Details

NPI number 1285735993
LBN Legal business name Rudolph, Laurel A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated May 11th, 2011 - about 15 years ago

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 1285735993 NPPES
Wisconsin MEDICAID 31612800

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