Provider Demographics
NPI:1801046503
Name:RUFF, BRADY SCOTT (PA - C)
Entity type:Individual
Prefix:
First Name:BRADY
Middle Name:SCOTT
Last Name:RUFF
Suffix:
Gender:M
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 N 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:MT
Mailing Address - Zip Code:59327-0268
Mailing Address - Country:US
Mailing Address - Phone:406-346-2161
Mailing Address - Fax:
Practice Address - Street 1:383 N 17TH AVE
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MT
Practice Address - Zip Code:59327-0268
Practice Address - Country:US
Practice Address - Phone:406-346-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT542363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant