Provider Demographics
NPI:1487761375
Name:RUTLEDGE, WILLIAM MARTIN JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MARTIN
Last Name:RUTLEDGE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:610 STRICKLAND DR
Mailing Address - Street 2:STE 200 C
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4786
Mailing Address - Country:US
Mailing Address - Phone:409-883-3298
Mailing Address - Fax:409-883-3220
Practice Address - Street 1:610 STRICKLAND DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4784
Practice Address - Country:US
Practice Address - Phone:409-883-3201
Practice Address - Fax:409-883-3220
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-10-06
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Provider Licenses
StateLicense IDTaxonomies
TXF4463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131023702Medicaid
TX080109238OtherRAILROAD MEDICARE
TX84945FMedicare PIN
TXD67703Medicare UPIN