Individual
JACK RUSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HOPPIN ST STE 305, PROVIDENCE, RI 02903-4141
(401) 444-5980
(401) 444-3873
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4712
(401) 444-6220
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD15912
RI
Other
Enumeration date
06/04/2010
Last updated
07/21/2022
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