Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 96 | OK |
N | 222Z00000X | Podiatrist | 96 | OK |
Y | 224P00000X | Prosthetist | 96 | OK |
NPI | 1326575630 |
---|---|
Provider Name | Mr. Steven Edward Rutledge |
First Address | Enid, OK 73701-5860 |
Second Address | Enid, OK 73701-5860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2017 |
Last Update Date | 17/05/2017 |