Provider Demographics
NPI:1194246314
Name:SMITH, EILEEN RUGGLES (MD)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:RUGGLES
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4602 EASTPARK BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-2002
Practice Address - Country:US
Practice Address - Phone:608-242-2888
Practice Address - Fax:608-662-4482
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2024-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2019028864208600000X
WI83418208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery