Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 13786 | AL |
NPI | 1063470250 |
---|---|
Provider Name | Dr. Ruth Yates |
First Address | Huntsville, AL 35801-4224 |
Second Address | Huntsville, AL 35801-4224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 29/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E90253 | (02) | AL |