Provider Demographics
NPI:1972216927
Name:MCPHERSON, RUDOLPH ARTHUR SR
Entity Type:Individual
Prefix:MR
First Name:RUDOLPH
Middle Name:ARTHUR
Last Name:MCPHERSON
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S MARSHALL ST UNIT 1083
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-0247
Mailing Address - Country:US
Mailing Address - Phone:336-343-2672
Mailing Address - Fax:
Practice Address - Street 1:521 ALAMANNI CT
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-4472
Practice Address - Country:US
Practice Address - Phone:336-343-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000043427182172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver