Individual
RUTVI NORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
668 SKYLINE DR, JACKSON, TN 38301-3951
(731) 426-8434
Mailing address
668 SKYLINE DR, JACKSON, TN 38301-3951
(731) 424-2414
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
64611
TN
207W00000X
Ophthalmology Physician
E-12822
AR
Other
Enumeration date
05/03/2016
Last updated
10/21/2022
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