Individual
GEORGE RODGER RUTHERFORD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
211 4TH ST, ALEXANDRIA, LA 71301-8421
(318) 442-5399
(318) 442-1586
Mailing address
PO BOX 5887, ALEXANDRIA, LA 71307-5887
(318) 442-5399
(318) 442-1586
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
218233
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN153570
LA NURSING BOARD
LA
Enumeration date
01/14/2021
Last updated
01/14/2021
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