Provider Demographics
NPI:1770916041
Name:RUPARD & MACKENS MEDICAL GROUP PLLC
Entity type:Organization
Organization Name:RUPARD & MACKENS MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:RUPARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-685-9260
Mailing Address - Street 1:120 FRANK MARTIN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7194
Mailing Address - Country:US
Mailing Address - Phone:931-735-6273
Mailing Address - Fax:931-735-6275
Practice Address - Street 1:120 FRANK MARTIN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7194
Practice Address - Country:US
Practice Address - Phone:931-735-6273
Practice Address - Fax:931-735-6275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty