Provider Demographics
NPI:1639178304
Name:RUFF, THOMAS M (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:RUFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 LITTLE YORK RD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-5800
Mailing Address - Country:US
Mailing Address - Phone:937-454-9527
Mailing Address - Fax:937-454-9532
Practice Address - Street 1:4160 LITTLE YORK RD
Practice Address - Street 2:STE. 20
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-5800
Practice Address - Country:US
Practice Address - Phone:937-454-9527
Practice Address - Fax:937-454-9532
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006163207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000009514OtherANTHEM
OHP00905895OtherRAILROAD MEDICARE PIN
OH0128070Medicaid
OH000000009514OtherANTHEM
OH4126561Medicare PIN
OH4126563Medicare PIN