Provider Demographics
NPI:1801132964
Name:RUBY, TONYA GAIL (PA)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:GAIL
Last Name:RUBY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-9571
Mailing Address - Fax:606-408-6061
Practice Address - Street 1:613 23RD ST STE G10
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2886
Practice Address - Country:US
Practice Address - Phone:606-408-5864
Practice Address - Fax:606-408-6499
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2022-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH003649363AM0700X
KY2302363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical