Individual
DR. PHILLIP PAUL RUPPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3309 WEDGEWOOD LN, THE VILLAGES, FL 32162-7177
(352) 391-1220
(352) 391-9247
Mailing address
1950 LAUREL MANOR DR, BLDG. 240, THE VILLAGES, FL 32162-5603
(352) 391-1220
(352) 391-9247
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1057
WI
103T00000X
Psychologist
1057057
WI
103TC0700X
Clinical Psychologist
Primary
1057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39045600
—
WI
Enumeration date
07/28/2006
Last updated
11/12/2009
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