Organization
PAUL RUST INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL WESLEY RUST LCSW, LMFT (PRESIDENT/OWNER)
(479) 484-1111
Entity
Organization
Contact information
Practice address
5111 ROGERS AVE., SUITE 504, FORT SMITH, AR 72903
(479) 484-1111
(479) 484-1111
Mailing address
5111 ROGERS AVE., SUITE 504, FORT SMITH, AR 72903
(479) 484-1111
(479) 484-1111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C237
AR
106H00000X
Marriage & Family Therapist
M9803014
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5G027
MEDICARE PTAN
AR
Enumeration date
07/10/2006
Last updated
08/25/2008
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