Provider Demographics
NPI:1194813550
Name:RUTLEDGE, LADONNA PATRICE (MD)
Entity type:Individual
Prefix:
First Name:LADONNA
Middle Name:PATRICE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2870
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77404-2870
Mailing Address - Country:US
Mailing Address - Phone:979-323-9900
Mailing Address - Fax:
Practice Address - Street 1:1701 GOLDEN AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3121
Practice Address - Country:US
Practice Address - Phone:979-323-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4692207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology