Provider Demographics
NPI:1316903537
Name:RUGOWSKI, JAMES A (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:RUGOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 W MADISON STREET
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703
Mailing Address - Country:US
Mailing Address - Phone:715-832-5454
Mailing Address - Fax:715-832-2991
Practice Address - Street 1:233 E LASALLE AVENUE
Practice Address - Street 2:
Practice Address - City:BARRON
Practice Address - State:WI
Practice Address - Zip Code:54812
Practice Address - Country:US
Practice Address - Phone:715-832-5454
Practice Address - Fax:715-832-2991
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI180240202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1523617OtherMEDICA UBH UHC
WI30973300Medicaid
MN017L6RUOtherBCBS MN
MN637871021354OtherPREFERRED ONE
GAP00123797OtherMEDICARE RAILROAD
WI7276OtherSECURITY HEALTH PLAN
MNHP37590OtherHEALTH PARTNERS
WI30973300Medicaid