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NPI 1063822393

NPI 1063822393 : RUTH LAUREN SACKS M.D. : ATLANTA, GA

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General NPI Number Information
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    NPI Number           |    1063822393
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    Entity Type          |    Individual 
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    Provider Name        |    RUTH LAUREN SACKS M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/08/2014
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    Last Update Date     |    11/19/2020
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Provider Practice Location Address
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    Address Line         |    1365 CLIFTON RD NE 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30322-1013
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    Country              |    US
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    Telephone            |    404-251-5266
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1365 CLIFTON RD NE 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30322-1013
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    Country              |    US
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    Telephone            |    404-778-1900
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RX0202X
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    Taxonomy Name        |    Medical Oncology Physician
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    License Number       |    85784
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    License Number State |    GA
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