Provider Demographics
NPI:1801874326
Name:RUFF, STAN J (MD)
Entity type:Individual
Prefix:
First Name:STAN
Middle Name:J
Last Name:RUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STANLEY
Other - Middle Name:JAMES
Other - Last Name:RUFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-345-2205
Mailing Address - Fax:541-345-4480
Practice Address - Street 1:360 S GARDEN WAY
Practice Address - Street 2:STE 290
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8173
Practice Address - Country:US
Practice Address - Phone:541-345-2205
Practice Address - Fax:541-345-4480
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10102208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR256198Medicaid
ORR136824Medicare PIN
OR256198Medicaid