Rutan, Charles Hugh
Rutan, Charles Hugh is an sole proprietor health care provider with primary practice located at 224 Elm St , Clinton IN 47842-2312. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Rutan, Charles Hugh can be contacted via phone (765) 832-3292.Contact Information
Primary practice address
224 Elm St
Clinton IN 47842-2312
Phone: (765) 832-3292
Fax: (765) 832-9730
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002266A | Indiana |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 18002266A | Indiana |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 1800226A | Indiana |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 18002266A | Indiana |
Profile Details
| NPI number | 1487643268 |
|---|---|
| LBN Legal business name | Rutan, Charles Hugh |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 14th, 2005 |
| Last updated | Aug 2nd, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487643268 | NPPES |
| Indiana | Other | 351776119 | TRICARE |
| Indiana | Other | 000000087765 | TRICARE |
| Indiana | Other | 100243930C | TRICARE |
| Indiana | MEDICAID | 100243930 | TRICARE |
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