Provider Demographics
NPI:1366527384
Name:RUFFIN, JULIA (DPM)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 READING RD
Mailing Address - Street 2:#308
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2563
Mailing Address - Country:US
Mailing Address - Phone:513-761-4802
Mailing Address - Fax:
Practice Address - Street 1:169 ALDEN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4602
Practice Address - Country:US
Practice Address - Phone:513-761-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH002249213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0605830Medicaid
OH0950300001OtherDMERC NSC
OH332270OtherAMERIGROUP
OH000000372663OtherBLUECROSS/BLUESHIELD
OH0000000557502OtherANTHEM
OH480004293OtherRAILROAD MEDICARE PIN
OH0605830Medicaid
T80729Medicare UPIN