Provider Demographics
NPI:1508979964
Name:RUANTO, ARTURO NATADA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:NATADA
Last Name:RUANTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARTURO
Other - Middle Name:NATADA
Other - Last Name:RUANTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:202 SOUTH CHERRY ST.
Mailing Address - Street 2:
Mailing Address - City:OCILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31774
Mailing Address - Country:US
Mailing Address - Phone:229-468-5015
Mailing Address - Fax:229-468-5018
Practice Address - Street 1:202 SOUTH CHERRY ST.
Practice Address - Street 2:
Practice Address - City:OCILLA
Practice Address - State:GA
Practice Address - Zip Code:31774
Practice Address - Country:US
Practice Address - Phone:229-468-5015
Practice Address - Fax:229-468-5018
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13102207Q00000X
GA052819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4105211Medicaid
TN3183603Medicare ID - Type Unspecified
TN4105211Medicaid