Provider Demographics
NPI:1508892811
Name:QUARLES, RUTH F (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:F
Last Name:QUARLES
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 1:2600 STATE ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9393
Mailing Address - Country:US
Mailing Address - Phone:330-372-8800
Mailing Address - Fax:330-372-8999
Practice Address - Street 1:2600 STATE ROUTE 5
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-9393
Practice Address - Country:US
Practice Address - Phone:330-372-8800
Practice Address - Fax:330-372-8999
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0531446Medicaid
OH105289OtherUNITED HEALTHCARE
OH341341025040OtherCARESOURCE
OH000000243197OtherANTHEM BC/BS
OHQ022561OtherHOMETOWN
OH78935OtherHEALTH ASSURANCE
OHJ49709OtherSUMMACARE
OH$$$$$$$$$OtherTRICARE/HEALTHNET
OHQ022561OtherHOMETOWN
OH$$$$$$$$$008OtherMEDICAL MUTUAL OF OHIO
OHA81955Medicare UPIN
OH0531446Medicaid