| Paul Rust Inc. | |
|
5111 Rogers Ave. Suite 504 Fort Smith AR 72903 | |
| (479) 484-1111 | |
| (479) 484-1111 |
| Full Name | Paul Rust Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 5111 Rogers Ave., Fort Smith, Arkansas |
| Authorized Official Name and Position | Paul Wesley Rust (PRESIDENT/OWNER) |
| Authorized Official Contact | 4794841111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Rust Inc. 5111 Rogers Ave. Suite 504 Fort Smith AR 72903 Ph: (479) 484-1111 | Paul Rust Inc. 5111 Rogers Ave. Suite 504 Fort Smith AR 72903 Ph: (479) 484-1111 |
| NPI Number | 1184657108 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 08/25/2008 |
| Medicare PECOS PAC ID | 1355416256 |
|---|---|
| Medicare Enrollment ID | O20080812000238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184657108 | NPI | - | NPPES |
| 5G027 | Other | AR | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C237 (Arkansas) | Primary |
| 106H00000X | Marriage & Family Therapist | M9803014 (Arkansas) | Secondary |
| Provider Name | Paul W Rust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871750950 PECOS PAC ID: 1951345545 Enrollment ID: I20050614001419 |
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