Healthcare Provider Details

I. General information

NPI: 1598727901
Provider Name (Legal Business Name): RUTH ANN DOOLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 W TECH RD
MIAMISBURG OH
45342-0955
US

IV. Provider business mailing address

PO BOX 933421
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-5725
  • Fax: 937-350-3050
Mailing address:
  • Phone: 937-641-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35066814
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: