Individual
RUTH ELAINE FEREDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
107 E POST AVE, COALGATE, OK 74538-3004
(580) 927-2828
(580) 258-3000
Mailing address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-3614
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
950
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089380A
—
OK
Enumeration date
08/19/2006
Last updated
10/08/2024
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