Provider Demographics
NPI:1568492239
Name:RUGGS, STEVEN JOE (PT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JOE
Last Name:RUGGS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:JOE
Other - Last Name:RUGGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 721505
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-8163
Mailing Address - Country:US
Mailing Address - Phone:405-202-3670
Mailing Address - Fax:405-310-6203
Practice Address - Street 1:3048 CLASSEN BLVD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4055
Practice Address - Country:US
Practice Address - Phone:405-310-6201
Practice Address - Fax:405-310-6203
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT1983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731605159OtherTAX ID
OKOK404227Medicare PIN
OK800522294Medicare PIN