Individual
CONNOR BLAINE RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801
(405) 273-5236
Mailing address
2307 S GORDON COOPER DRIVE, SHAWNEE, OK 74801
(405) 273-5236
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38079
OK
Other
Enumeration date
07/09/2020
Last updated
08/27/2024
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