| Mark Rukavina, MD | |
|
1100 Richmond Road, Irvine, KY 40336-0524 | |
| (606) 723-7706 | |
| (606) 726-9410 |
| Full Name | Mark Rukavina |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1100 Richmond Road, Irvine, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619923117 | NPI | - | NPPES |
| 64226863 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 22686 (Kentucky) | Secondary |
| 207Q00000X | Family Medicine | 22686 (Kentucky) | Primary |
| Entity Name | Southeastern Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050302000285 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Rukavina, MD Po Box 636493, Cincinnati, OH 45263-6493 Ph: (513) 981-5130 | Mark Rukavina, MD 1100 Richmond Road, Irvine, KY 40336-0524 Ph: (606) 723-7706 |
Dr. Tamera Shea Spangler, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1100 Richmond Rd, Irvine, KY 40336 Phone: 606-723-7706 Fax: 606-726-9410 | |
Dr. John-michael Mcgaugh, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 30 Stacy Lane Rd, Irvine, KY 40336 Phone: 606-723-0665 Fax: 606-723-0680 | |
Herbert W Long, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 417 River Dr, Irvine, KY 40336 Phone: 606-723-0399 Fax: 606-723-0379 |