Healthcare Provider Details

I. General information

NPI: 1275887366
Provider Name (Legal Business Name): RUTH ESTHER SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUTH ESTHER OLSON MD

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MARSH ST
MANKATO MN
56001-4752
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 507-625-4031
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number71414
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number66625
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01074582A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: