W L Rutledge Md Pa | |
9712 W Markham St Little Rock AR 72205-2124 | |
(501) 225-3384 | |
Not Available |
Full Name | W L Rutledge Md Pa |
---|---|
Speciality | Family Medicine |
Location | 9712 W Markham St, Little Rock, Arkansas |
Authorized Official Name and Position | William L Rutledge (PRESIDENT/OWNER) |
Authorized Official Contact | 5012253384 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
W L Rutledge Md Pa 1501 N University Ave Suite 500 Little Rock AR 72207-5242 Ph: (501) 661-8207 | W L Rutledge Md Pa 9712 W Markham St Little Rock AR 72205-2124 Ph: (501) 225-3384 |
NPI Number | 1427297902 |
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Provider Enumeration Date | 02/06/2009 |
Last Update Date | 03/25/2010 |
Medicare PECOS PAC ID | 1153478755 |
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Medicare Enrollment ID | O20090420000107 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427297902 | NPI | - | NPPES |
105362001 | Medicaid | AR | |
1003820036 | Other | AR | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | R3422 (Arkansas) | Primary |
208600000X | Surgery | R3422 (Arkansas) | Secondary |
Provider Name | William L Rutledge |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1003820036 PECOS PAC ID: 0345308722 Enrollment ID: I20081029000640 |
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