Provider Demographics
NPI:1902103252
Name:RUCH, JAMES N (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:N
Last Name:RUCH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 EMERGENCY LN
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5536
Mailing Address - Country:US
Mailing Address - Phone:863-386-4302
Mailing Address - Fax:863-382-0534
Practice Address - Street 1:3700 EMERGENCY LN
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5536
Practice Address - Country:US
Practice Address - Phone:863-386-4302
Practice Address - Fax:863-382-0534
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1936363AM0700X
FLPA9106082363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical