Provider Demographics
NPI:1902135957
Name:VUCHINICH, RUDY (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUDY
Middle Name:
Last Name:VUCHINICH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:RUDOLPH
Other - Middle Name:
Other - Last Name:VUCHINICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:700 19TH ST S
Mailing Address - Street 2:BIRMINGHAM VA MEDICAL CENTER
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1927
Mailing Address - Country:US
Mailing Address - Phone:205-492-4290
Mailing Address - Fax:205-428-9240
Practice Address - Street 1:700 19TH ST S
Practice Address - Street 2:BIRMINGHAM VA MEDICAL CENTER
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1927
Practice Address - Country:US
Practice Address - Phone:205-492-4290
Practice Address - Fax:205-428-9240
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1074103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical