Provider Demographics
NPI:1619981214
Name:RUFFNER, JOSEPH DAVID JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DAVID
Last Name:RUFFNER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 MAIN ST
Mailing Address - Street 2:PO BOX 1228
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6712
Mailing Address - Country:US
Mailing Address - Phone:207-846-3900
Mailing Address - Fax:207-846-3962
Practice Address - Street 1:158 MAIN ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6712
Practice Address - Country:US
Practice Address - Phone:207-846-3900
Practice Address - Fax:207-846-3962
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0157662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM9952Medicare ID - Type UnspecifiedMEDICARE ID