Organization
RUSTON CLINIC COMPANY LLC
Active
Parent organization
RUSTON CLINIC COMPANY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSTON CLINIC COMPANY LLC
Authorized official
SOPHIA L ARWOOD (DIRECTOR OF PHYSICIAN OPERATIONS)
(615) 628-6038
Entity
Organization
Contact information
Practice address
401 E VAUGHN AVE, RUSTON, LA 71270-5950
(318) 254-7590
(318) 254-2229
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 628-6038
(615) 628-6832
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1449202
—
LA
Enumeration date
01/19/2007
Last updated
09/10/2013
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