Individual
JOHN A RUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2193 NORTHLAKE PKWY, STE 114, TUCKER, GA 30084-4116
(770) 938-5974
(770) 939-7393
Mailing address
300 VILLAGE GREEN CIR SE, SUITE 200, SMYRNA, GA 30080-3476
(770) 384-0284
(770) 432-7638
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
407
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115519A
—
GA
01
—
237428
BLUE CROSS
—
01
—
406480290
MCR RAILROAD
—
01
—
518145
AETNA
—
Enumeration date
07/25/2006
Last updated
05/20/2008
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