Individual
THOMAS J RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1800 COBURG RD, EUGENE, OR 97401-4995
(541) 345-8760
Mailing address
PO BOX 1188, CORVALLIS, OR 97339-1188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
596
MT
363A00000X
Physician Assistant
Primary
PA155998
OR
Other
Enumeration date
11/05/2009
Last updated
11/11/2020
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