1013177971 NPI number — RUTH A YATES, MD

Table of content: KATHRYN GRACE HUGHES AGACNP (NPI 1679935894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013177971 NPI number — RUTH A YATES, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RUTH A YATES, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013177971
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
10/01/2008
NPI Reactivation Date:
04/24/2020

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 MADISON ST SE STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801-4253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-536-4401
Provider Business Mailing Address Fax Number:
256-536-3153

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 MADISON ST SE STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-4253
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-536-4401
Provider Business Practice Location Address Fax Number:
256-536-3153
Provider Enumeration Date:
06/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
YATES
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
256-536-4401

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  13786 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000084341 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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