Basic Information
| Provider Information | |||||||||
| NPI: | 1578774378 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUDESILL | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | HOGAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 ACKERMAN RD STE 2120 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432021559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933069 | ||||||||
| FaxNumber: | 6146850256 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 W WILSON BRIDGE RD STE 2101 | ||||||||
| Address2: | |||||||||
| City: | WORTHINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430852688 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933069 | ||||||||
| FaxNumber: | 6146850256 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2007 | ||||||||
| LastUpdateDate: | 03/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 35122194 | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.