Ruth D Mayforth
Pediatric Surgery
301 N 8th St Pav4a
Springfield
, Illinois 62701-1041
Ruth D Mayforth
Pediatric Surgery
301 N 8th St Pav4a
Springfield
, Illinois 62701-1041
(217) 545-7305
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Ruth D Mayforth
- Po Box 19655
- Springfield, IL
- Zip : 62794-9655
- Fax : (217) 545-7305
- Phone : (217) 545-0702
Second Address
- Ruth D Mayforth
- 301 N 8th St Pav4a
- Springfield, IL
- Zip : 62701-1041
- Fax : (217) 545-7305
- Phone : (217) 545-0702
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 036105117 | IL |
National Provider Identifier
| NPI | 1184610255 |
|---|---|
| Provider Name | Ruth D Mayforth |
| First Address | Springfield, IL 62794-9655 |
| Second Address | Springfield, IL 62701-1041 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/09/2005 |
| Last Update Date | 20/07/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036105117 | (05) | IL |
| H49561 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.