Individual
DR. GREGORY RUSIECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
123 THREE RIVERS DR NE, ROME, GA 30161-2300
(706) 295-3961
Mailing address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
97133
GA
390200000X
Student in an Organized Health Care Education/Training Program
12024
GA
Other
Enumeration date
06/12/2020
Last updated
09/29/2023
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