Healthcare Provider Details

I. General information

NPI: 1104061639
Provider Name (Legal Business Name): ARTHUR MERRIAM RUGGLES MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2008
Last Update Date: 12/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 CENTENARY BLVD. BLDG.3,, STE. 304 MEECE & ASSOCIATES, L.L.C.
SHREVEPORT LA
71104
US

IV. Provider business mailing address

PO BOX 52153
SHREVEPORT LA
71135-2153
US

V. Phone/Fax

Practice location:
  • Phone: 318-226-1555
  • Fax: 318-226-0406
Mailing address:
  • Phone: 318-797-7779
  • Fax: 318-797-7779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number763
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: