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General NPI Number Information
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NPI Number | 1235305954
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Entity Type | Organization
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Legal Business Name | HARRY R. RUTH, M.D.,P.C.
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 1107 COLLEGE AVE SUITE 2
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City | QUINCY
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State | IL
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Zip | 62301-2664
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Country | US
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Telephone | 217-228-3377
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Fax | 217-228-2657
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Provider Business Mailing Address
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Address Line | 1107 COLLEGE AVE SUITE 2
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City | QUINCY
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State | IL
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Zip | 62301-2664
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Country | US
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Telephone | 217-228-3377
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Fax | 217-228-2657
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MARCA JANE OWENS
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Credential |
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Telephone | 217-228-3377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | 036068434
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License Number State | IL
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