Organization
HARRY R. RUTH, M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARCA JANE OWENS (OFFICE MANAGER)
(217) 228-3377
Entity
Organization
Contact information
Practice address
1107 COLLEGE AVE, SUITE 2, QUINCY, IL 62301-2664
(217) 228-3377
(217) 228-2657
Mailing address
1107 COLLEGE AVE, SUITE 2, QUINCY, IL 62301-2664
(217) 228-3377
(217) 228-2657
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
036068434
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00122928
BLUE CROSS BLUE SHIELD
IL
05
—
036068434
—
IL
01
—
202444915
MEDICAID
MO
01
—
243437
HEALTHLINK
—
Enumeration date
05/02/2008
Last updated
05/02/2008
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