Ty Sanders Ruddell in Mesa - Sports Physician
Ty Sanders Ruddell - NPI 1982767349
Ty Sanders Ruddell is a Sports Physician in Mesa, Arizona. Ty Sanders Ruddell practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Ty Sanders Ruddell is 1982767349. The last update date is 2009-04-27.
Ty Sanders Ruddell's current location address is 4864 E Baseline Rd, Mesa, Arizona. You can contact this provider via phone number 4805581900 and fax number 4806336086. The mailing address for Ty Sanders Ruddell is 4864 E Baseline Rd, Mesa, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ty Sanders Ruddell |
|---|---|
| Address | 4864 E Baseline Rd, Mesa, Arizona |
| Phone Number | 4805581900 |
| Fax Number | 4806336086 |
| Sole Proprietor | N |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1982767349 |
|---|---|
| Provider Enumeration Date | 2006-12-18 |
| Last Updated Date | 2009-04-27 |
Provider Mailing Address Detail
| Address | 4864 E Baseline Rd |
|---|---|
| City | Mesa |
| State | Arizona (AZ) |
| Post Code | 852064629 |
| Phone Number | 4805581900 |
| Fax Number | 4806336086 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | 3661 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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What is the unique 10-digit identifier code assigned to Ty Sanders Ruddell by the Centers for Medicare & Medicaid Services?
The Ty Sanders Ruddell has been issued the NPI (National Provider Identifier) 1982767349 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Ty Sanders Ruddell?
The Ty Sanders Ruddell is physically situated at 4864 E Baseline Rd, in the city of Mesa, state of AZ, with the postal code 852064629.
What is Ty Sanders Ruddell's area of expertise and its corresponding taxonomy classification?
The Ty Sanders Ruddell's field of specialization is Sports Physician, and it falls under the taxonomy code 111Ns0005X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services issue the 1982767349 to Ty Sanders Ruddell?
The Ty Sanders Ruddell received its 1982767349 assignment from the Centers for Medicare & Medicaid Services on 2006-12-18.
As of what date were the details related to Ty Sanders Ruddell most recently updated or revised?
The information pertaining to Ty Sanders Ruddell, including its address, specialty, and other relevant details, was last updated or revised on 2009-04-27.
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