Provider Demographics
NPI:1538472337
Name:MICHAEL RULON, M.D., L.L.C.
Entity type:Organization
Organization Name:MICHAEL RULON, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:RULON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-779-3520
Mailing Address - Street 1:691 MURPHY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4346
Mailing Address - Country:US
Mailing Address - Phone:541-779-3520
Mailing Address - Fax:541-779-3702
Practice Address - Street 1:691 MURPHY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4346
Practice Address - Country:US
Practice Address - Phone:541-779-3520
Practice Address - Fax:541-779-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14214207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR807128000OtherREGENCE BLUE CROSS OF OREGON
OR272161Medicaid
000000008488OtherASANTE/HEALTH FUTURE
ORF07006Medicare UPIN