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General NPI Number Information
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NPI Number | 1912926437
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Entity Type | Individual
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Provider Name | ROBERT RUTH MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 8734 ORTEGA PARK DR
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City | NAVARRE
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State | FL
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Zip | 32566-4139
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Country | US
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Telephone | 850-904-2277
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Fax | 205-618-9706
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Provider Business Mailing Address
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Address Line | 107 DILWORTH ST
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City | GLENDIVE
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State | MT
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Zip | 59330-2053
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Country | US
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Telephone | 406-345-8901
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Fax | 406-345-8908
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | ME74008
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11461
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME74008
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License Number State | FL
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