Provider Demographics
NPI:1467486571
Name:LAVIGNE, RUTH FAYE (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:FAYE
Last Name:LAVIGNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-218-3516
Mailing Address - Fax:606-218-4540
Practice Address - Street 1:911 BYPASS RD BLDG A
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1689
Practice Address - Country:US
Practice Address - Phone:606-218-3516
Practice Address - Fax:606-218-4540
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY392342085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7690706OtherAETNA
OH2547588Medicaid
OH000000361685OtherANTHEM
OH36-01273OtherUNITED HEALTHCARE
IN200525660Medicaid
KY64096167Medicaid
OH36-01273OtherUNITED HEALTHCARE
IN200525660Medicaid