Provider Demographics
NPI:1285921767
Name:RULEY, ADAM THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:THOMAS
Last Name:RULEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:180 S 3RD ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1952
Mailing Address - Country:US
Mailing Address - Phone:618-233-7880
Mailing Address - Fax:618-222-4792
Practice Address - Street 1:180 S 3RD ST
Practice Address - Street 2:SUITE 400
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1952
Practice Address - Country:US
Practice Address - Phone:618-233-7880
Practice Address - Fax:618-222-4792
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125-060410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine