Provider Demographics
NPI:1093983686
Name:DR. TIMOTHY M RUFF, MD, PLLC
Entity Type:Organization
Organization Name:DR. TIMOTHY M RUFF, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:RUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-776-1383
Mailing Address - Street 1:1276 BRIDGETON PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8340
Mailing Address - Country:US
Mailing Address - Phone:615-776-1383
Mailing Address - Fax:
Practice Address - Street 1:1276 BRIDGETON PARK DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8340
Practice Address - Country:US
Practice Address - Phone:615-776-1383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37562261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
291876OtherGREAT WEST LIFE & ANNUITY
236232OtherCIGNA
4065623OtherBLUE CROSS BLUE SHIELD-TN
2135860OtherFIRST HEALTH
7086510OtherAETNA
4065623OtherBLUE PREFERRED
4065623OtherBLUE SELECT
4065623OtherBLUE CARE- TENNCARE
H95029OtherHEALTHSPRINGS
4065623OtherBLUE CLASSIC
TN4065623Medicaid
4065623OtherBLUE PREFERRED
=========OtherACCORDIA NATIONAL
=========OtherPHCS
236232OtherCIGNA
4065623OtherBLUE CROSS BLUE SHIELD-TN
4065623OtherBLUE CARE- TENNCARE
=========OtherGHI
TN4065623Medicaid
=========OtherHUMANA