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Individual

MARY CATHERINE RUTHERFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1023 NEW MOODY LN, SUITE 201, LA GRANGE, KY 40031-9177
(502) 225-4480
(502) 225-9169
Mailing address
1023 NEW MOODY LN, SUITE 201, LA GRANGE, KY 40031-9177
(502) 225-4480
(502) 225-9169

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40265
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000740355
ANTHEM
KY
05
64120769
KY
Enumeration date
07/12/2006
Last updated
12/03/2012
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