Provider Demographics
NPI:1790834117
Name:HAYES, RUTH ANNA (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANNA
Last Name:HAYES
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 1:15 PETERSON PL
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2132
Mailing Address - Country:US
Mailing Address - Phone:937-382-2013
Mailing Address - Fax:937-382-5814
Practice Address - Street 1:586 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177
Practice Address - Country:US
Practice Address - Phone:937-382-8500
Practice Address - Fax:937-382-5814
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7367321OtherPTN-FAMILY HEALTH CENTER
OH0139111Medicaid
7367321OtherPTN-FAMILY HEALTH CENTER
OH0139111Medicaid