Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Rusley, MD

Individual provider Pediatric Adolescent Medicine Physician · NPI 1639499395

Jack Rusley, MD is a Pediatric Adolescent Medicine Physician in Providence, Rhode Island. Works from 2 locations. Licensed in Rhode Island.

Licensed in
RI
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1 Hoppin St Ste 305
Providence, RI 02903-4141
Phone: (401) 444-5980
Fax: (401) 444-3873
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 593 Eddy St, Providence, RI 02903-4923 — (401) 444-4712

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X · Licence MD15912 (RI)

Record details

NPI number1639499395
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 4, 2010
Last updated in NPPESJuly 21, 2022

Other providers in Providence