Provider Demographics
NPI:1447014980
Name:RUGNATH, NICKHIL
Entity type:Individual
Prefix:
First Name:NICKHIL
Middle Name:
Last Name:RUGNATH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CHADWYCK PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6508
Mailing Address - Country:US
Mailing Address - Phone:601-896-1029
Mailing Address - Fax:
Practice Address - Street 1:100 CHADWYCK PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6508
Practice Address - Country:US
Practice Address - Phone:601-896-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program