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RUTH BERTRAM LAIRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4805 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3835
(405) 636-1506
(405) 636-1511
Mailing address
4805 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3835
(405) 636-1506
(405) 636-1511

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2472
OK
363A00000X
Physician Assistant
2472
OK

Other

Enumeration date
01/17/2015
Last updated
04/04/2018
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