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General NPI Number Information
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NPI Number | 1174666101
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Entity Type | Individual
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Provider Name | PATRICK PAUL RUGGLES OD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 3801 WILDER RD STE 4
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City | BAY CITY
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State | MI
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Zip | 48706-2301
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Country | US
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Telephone | 989-778-1414
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Fax | 989-402-1467
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Provider Business Mailing Address
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Address Line | 2140 ETHEL ST
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City | SAGINAW
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State | MI
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Zip | 48603-4013
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Country | US
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Telephone | 989-878-0389
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901003089
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License Number State | MI
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