Provider Demographics
NPI:1811955453
Name:THOMPSON, RUTH M (DO)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SE FRANK PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2300
Mailing Address - Country:US
Mailing Address - Phone:918-331-1104
Mailing Address - Fax:918-331-1446
Practice Address - Street 1:3500 SE FRANK PHILLIPS BLVD.
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2300
Practice Address - Country:US
Practice Address - Phone:918-331-1104
Practice Address - Fax:918-331-1446
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2557207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKF15301Medicare UPIN