Provider Demographics
NPI:1790009652
Name:STAGGERS, RUCER LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:RUCER
Middle Name:LEWIS
Last Name:STAGGERS
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 1:6666 SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELBERTA
Mailing Address - State:AL
Mailing Address - Zip Code:36530
Mailing Address - Country:US
Mailing Address - Phone:251-987-1557
Mailing Address - Fax:251-987-1558
Practice Address - Street 1:6666 SHORE DRIVE
Practice Address - Street 2:
Practice Address - City:ELBERTA
Practice Address - State:AL
Practice Address - Zip Code:36530
Practice Address - Country:US
Practice Address - Phone:251-987-1557
Practice Address - Fax:251-987-1558
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine