Individual
DR. JASON W. RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2775 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-7307
(610) 861-8080
(610) 997-5762
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD067886L
PA
207X00000X
Orthopaedic Surgery Physician
MD067886L
PA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
MD067886L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017598980001
—
PA
Enumeration date
06/15/2006
Last updated
08/20/2024
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