| Dr Mark C Rusten, MD | |
|
1050 W 10th St, Rolla, MO 65401-2905 | |
| (573) 364-9000 | |
| (573) 202-2484 |
| Full Name | Dr Mark C Rusten |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 25 Years |
| Location | 1050 W 10th St, Rolla, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912930777 | NPI | - | NPPES |
| 000000727593 | Other | KY | BLUE CROSS BLUE SHIELD |
| 64105109 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 39450 (Kentucky) | Secondary |
| 207Y00000X | Otolaryngology | 2013000673 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Phelps County Regional Medical Center | Rolla, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pcrmc Medical Group Inc | 1557454063 | 99 |
| Entity Name | Southeast Missouri Hospital Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558311522 PECOS PAC ID: 9133024334 Enrollment ID: O20031201000775 |
| Entity Name | Phelps County Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891766051 PECOS PAC ID: 2860391158 Enrollment ID: O20040106000405 |
| Entity Name | Pcrmc Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124237227 PECOS PAC ID: 1557454063 Enrollment ID: O20070829000437 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark C Rusten, MD 1050 W 10th St, Rolla, MO 65401-2905 Ph: (573) 364-9000 | Dr Mark C Rusten, MD 1050 W 10th St, Rolla, MO 65401-2905 Ph: (573) 364-9000 |
Judyann Krenning, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 600 Blues Lake Pkwy, Rolla, MO 65401 Phone: 573-364-8822 Fax: 573-341-5969 |