Basic Information
| Provider Information | |||||||||
| NPI: | 1689052169 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUCH | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | CHARRUF | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7628 | ||||||||
| Address2: | |||||||||
| City: | CHESTNUT MOUNTAIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305020628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702199000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 743 SPRING ST NE | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305013715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702199000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2015 | ||||||||
| LastUpdateDate: | 08/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 80088 | GA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 2017-02255 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.