Provider Demographics
NPI:1689662785
Name:RUTLEDGE, WILLIAM M (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:RUTLEDGE
Suffix:
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 1:18218 SR 37 E
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IN
Mailing Address - Zip Code:46743
Mailing Address - Country:US
Mailing Address - Phone:260-489-5446
Mailing Address - Fax:260-489-6997
Practice Address - Street 1:18218 SR 37 E
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IN
Practice Address - Zip Code:46743
Practice Address - Country:US
Practice Address - Phone:260-489-5446
Practice Address - Fax:260-489-6997
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032640A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0524810Medicaid
IN1811970858Medicare NSC
OH7421861Medicare PIN
OH0524810Medicaid
INM400033305Medicare PIN