# CLHG-RUSTON LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Ruston Physician Practices
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245964931
- **Authorized official:** ROCK MATTHEW BORDELON (OWNER)
- **Authorized official phone:** (318) 629-3269

## Contact information

- **Practice address:** 401 E VAUGHN AVE, RUSTON, LA 71270-5950
- **Practice address phone:** (318) 254-2100
- **Mailing address:** 401 E VAUGHN AVE, RUSTON, LA 71270-5950
- **Mailing address phone:** (318) 254-2453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/11/2022
- **Last updated:** 09/06/2022