Provider Demographics
NPI:1780754259
Name:RUTH, LAURA J (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:RUTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:841 E PLACITA DE ARNOLDO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2734
Mailing Address - Country:US
Mailing Address - Phone:520-797-1891
Mailing Address - Fax:520-297-9765
Practice Address - Street 1:841 E PLACITA DE ARNOLDO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-2734
Practice Address - Country:US
Practice Address - Phone:520-797-1891
Practice Address - Fax:520-297-9765
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ20325207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ067943Medicaid
AZZ83602Medicare PIN
F03091Medicare UPIN