Basic Information
| Provider Information | |||||||||
| NPI: | 1487650081 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUGER | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 W COUNTY LINE RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | HIGHLANDS RANCH | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801292360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037910418 | ||||||||
| FaxNumber: | 3037911849 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 W COUNTY LINE RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | HIGHLANDS RANCH | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801292360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037910418 | ||||||||
| FaxNumber: | 3037911849 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2005 | ||||||||
| LastUpdateDate: | 04/04/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 98-381 | NM | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | T4805 | 05 | NM | MEDICAID |