Provider Demographics
NPI:1649465386
Name:RUTLEDGE, ESTELLE ALEXIS (MD)
Entity type:Individual
Prefix:DR
First Name:ESTELLE
Middle Name:ALEXIS
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 VILLA VISTA LOOP
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-6708
Mailing Address - Country:US
Mailing Address - Phone:501-960-1390
Mailing Address - Fax:
Practice Address - Street 1:38 VILLA VISTA LOOP
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-6708
Practice Address - Country:US
Practice Address - Phone:501-960-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE6039207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1649465386OtherBCBS
AR177675001Medicaid
AR1649465386OtherBCBS