Individual
MARK RUKAVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 RICHMOND ROAD, IRVINE, KY 40336-0524
(606) 723-7706
(606) 726-9410
Mailing address
PO BOX 636493, CINCINNATI, OH 45263-6493
(513) 981-5130
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22686
KY
207Q00000X
Family Medicine Physician
Primary
22686
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64226863
—
KY
Enumeration date
05/26/2006
Last updated
03/03/2015
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