MEDICARE: THEODORE A RUFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	20876	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477529139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THEODORE A RUFF MD

Provider Business Mailing Address
First Line	:	2525 NW EXPRESSWAY
Second Line	:	SUITE 610
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112
Country	:	US
Telephone Number	:	405-286-9465
Fax Number	:	405-286-9462

Provider Business Practice Location Address
First Line	:	1001 S DOUGLAS BLVD
Second Line	:	SUITE A
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5251
Country	:	US
Telephone Number	:	405-733-3030
Fax Number	:	405-733-3865

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	08/08/2016

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Directions to “ THEODORE A RUFF MD” Practice Location

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