Individual
THOMAS WILLIAM RUSING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
811 AINSWORTH DR, SUITE 103, PRESCOTT, AZ 86301-1687
(928) 771-5550
(928) 445-9209
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5987
(928) 458-2039
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14828
AZ
208C00000X
Colon & Rectal Surgery Physician
14828
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0185310
BLUE CROSS BLUE SHIELD ID
AZ
01
—
11330927
CAQH PROVIDER ID #
AZ
01
—
21-113- K828
STATE COMPENSATION ID#
AZ
01
—
257990
AHCCCS ID #
AZ
Enumeration date
08/01/2006
Last updated
09/20/2016
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