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NPI Code Detail

MEDICARE: DAVID M RUTLEDGE MD

MEDICARE: DAVID M RUTLEDGE 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
1208600000XSurgery PhysicianJ8751TX
2208600000XSurgery Physician2316WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2020054589OTHERRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1588681183
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID M RUTLEDGE MD
Provider Business Mailing Address
First Line : PO BOX 961205
Second Line :
City : FORT WORTH
State : TX
Zip : 76161-1205
Country : US
Telephone Number : 817-740-8400
Fax Number : 817-263-3702
Provider Business Practice Location Address
First Line : 7201 HAWKINS VIEW DR STE 151
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-3934
Country : US
Telephone Number : 817-263-7200
Fax Number : 817-377-6558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 01/12/2023

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Directions to “ DAVID M RUTLEDGE MD” Practice Location

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