Provider Demographics
NPI:1114458981
Name:RUDD, DAVID MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:RUDD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5246 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9136
Mailing Address - Country:US
Mailing Address - Phone:225-757-4142
Mailing Address - Fax:225-757-4230
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-815-1292
Practice Address - Fax:601-984-5110
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2021-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA322837207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine