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

Phillip Robert Rutledge, PA

Individual provider Physician Assistant · NPI 1619592953

Phillip Robert Rutledge, PA is a Physician Assistant in Kemmerer, Wyoming. Graduated from Wake Forest University School of Medicine in 2020, 6 years ago. Practices with Draper Dermatology PC, a 6-clinician group and accepts Medicare assignment.

Years since qualifying
6
Trained at
Wake Forest University School of Medicine
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

711 Onyx St
Kemmerer, WY 83101-3214
Phone: (307) 877-4401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1619592953
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 12, 2020
Last updated in NPPESOctober 26, 2020
Certification dateOctober 26, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolWAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Draper Dermatology Pc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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