Provider Demographics
NPI:1306264155
Name:RUDNER, JOSHUA R (DO)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:R
Last Name:RUDNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1327
Mailing Address - Country:US
Mailing Address - Phone:603-934-2060
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:LAKES REGION GENERAL HOSPITAL ER
Practice Address - Street 2:80 HIGHLAND STREET
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3235
Practice Address - Country:US
Practice Address - Phone:603-527-2819
Practice Address - Fax:603-527-2984
Is Sole Proprietor?:No
Enumeration Date:2014-03-30
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19001207P00000X
PAOS018813207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine