Healthcare Provider Details

I. General information

NPI: 1124009147
Provider Name (Legal Business Name): RUTH ELLEN HASKINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 PRAIRIE CITY RD
FOLSOM CA
95630-9554
US

IV. Provider business mailing address

3444 SMOKEY MOUNTAIN CIR
EL DORADO HILLS CA
95762-7326
US

V. Phone/Fax

Practice location:
  • Phone: 916-985-9366
  • Fax: 916-608-8749
Mailing address:
  • Phone: 916-941-0779
  • Fax: 916-608-8749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG064514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: