Provider Demographics
NPI:1639372931
Name:ARCHER, RUTH ELLEN
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ELLEN
Last Name:ARCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 S 93RD EAST AVE APT 120
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1634
Mailing Address - Country:US
Mailing Address - Phone:918-749-6095
Mailing Address - Fax:918-560-0137
Practice Address - Street 1:650 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4429
Practice Address - Country:US
Practice Address - Phone:918-587-9471
Practice Address - Fax:918-560-0137
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No174400000XOther Service ProvidersSpecialist