MEDICARE: ALEX RUTH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD0000005770	TN

General Provider Information

NPI Number	:	1225019987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX RUTH M.D.

Provider Business Mailing Address
First Line	:	7733 OAK RIDGE HWY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37931-3343
Country	:	US
Telephone Number	:	865-470-2560
Fax Number	:	865-691-5883

Provider Business Practice Location Address
First Line	:	7733 OAK RIDGE HWY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37931-3343
Country	:	US
Telephone Number	:	865-470-2560
Fax Number	:	865-691-5883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	01/20/2016

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