Michiel Brent Rudder, FNP MSW | |
622 West Market Street, Bolivar, TN 38008 | |
(731) 658-4500 | |
(731) 658-4545 |
Full Name | Michiel Brent Rudder |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 622 West Market Street, Bolivar, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841287109 | NPI | - | NPPES |
3909409 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | RN131561 (Tennessee) | Primary |
Entity Name | Physicians Quality Care Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528240256 PECOS PAC ID: 4385728518 Enrollment ID: O20080227000370 |
Mailing Address | Practice Location Address |
---|---|
Michiel Brent Rudder, FNP MSW Po Box 11567, Jackson, TN 38308-0126 Ph: (731) 661-0086 | Michiel Brent Rudder, FNP MSW 622 West Market Street, Bolivar, TN 38008 Ph: (731) 658-4500 |
Dr. Robert Wayne Dunavant, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 610 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-7111 Fax: 731-658-4328 | |
Dr. John Lee Blankenship, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Dr. Samuel Terry Johnson Jr., M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Lawrence Diaz, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Olufemi E Soyinka, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Dr. Nithyananda Pakkala, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 630 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-6011 Fax: 731-658-9884 | |
Elizabeth M Rodriguez, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 622 W Market St, Bolivar, TN 38008 Phone: 731-658-2885 Fax: 731-658-2886 |