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Individual

JOSEPH E CARRUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
104 FAIRVIEW PARK DR, DUBLIN, GA 31021
(478) 272-1366
(478) 277-1922
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(478) 275-3166
(478) 277-1922

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
019653
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000193355G
GA
Enumeration date
01/05/2006
Last updated
09/18/2015
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