| Brent A Rudisel, DO | |
|
503a N 1st St, Fairfield, IL 62837-2443 | |
| (618) 842-2491 | |
| (618) 842-2497 |
| Full Name | Brent A Rudisel |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 503a N 1st St, Fairfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477652287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036111757 (Illinois) | Primary |
| 207P00000X | Emergency Medicine | 02002497A (Indiana) | Secondary |
| Entity Name | Crossroads Emergency Physicians Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023033982 PECOS PAC ID: 3072419712 Enrollment ID: O20031211000854 |
| Entity Name | Integritas Emergency Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790128817 PECOS PAC ID: 7113167446 Enrollment ID: O20130710000760 |
| Entity Name | Statera Health Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043874449 PECOS PAC ID: 0244565729 Enrollment ID: O20190708000284 |
| Mailing Address | Practice Location Address |
|---|---|
| Brent A Rudisel, DO 503a N 1st St, Fairfield, IL 62837-2443 Ph: (618) 842-2491 | Brent A Rudisel, DO 503a N 1st St, Fairfield, IL 62837-2443 Ph: (618) 842-2491 |
Dr. Andrew Michael Britt, D.O Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 503a N 1st St, Fairfield, IL 62837 Phone: 618-842-2491 Fax: 618-842-2497 |