Healthcare Provider Details

I. General information

NPI: 1225411960
Provider Name (Legal Business Name): HANNA RUGGLES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 EXECUTIVE DR
NORWALK OH
44857
US

IV. Provider business mailing address

PO BOX 378
SANDUSKY OH
44871-0378
US

V. Phone/Fax

Practice location:
  • Phone: 419-668-4851
  • Fax: 419-663-5146
Mailing address:
  • Phone: 419-609-1112
  • Fax: 419-502-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number57.026453
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: