Individual
DR. RUDOLF W CISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1224 SHERWOOD PARK DR NE, GAINESVILLE, GA 30501-3445
(770) 287-0606
(770) 287-0159
Mailing address
1224 SHERWOOD PARK DR NE, GAINESVILLE, GA 30501-3445
(770) 287-0606
(770) 287-0159
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000596
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00409274A
—
GA
Enumeration date
07/15/2006
Last updated
01/05/2011
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