Healthcare Provider Details

I. General information

NPI: 1366527384
Provider Name (Legal Business Name): JULIA RUFFIN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 12/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ALDEN ST
DAYTON OH
45405-4602
US

IV. Provider business mailing address

10475 READING RD #308
CINCINNATI OH
45241-2563
US

V. Phone/Fax

Practice location:
  • Phone: 513-761-4802
  • Fax:
Mailing address:
  • Phone: 513-761-4802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number002249
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: