Provider Demographics
NPI:1144335779
Name:RUTH, STEPHEN JOSEPH (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:RUTH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 S 30TH ST
Mailing Address - Street 2:SEARS OPTICAL
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-4200
Mailing Address - Country:US
Mailing Address - Phone:740-522-8846
Mailing Address - Fax:740-522-8846
Practice Address - Street 1:771 S 30TH ST
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-4200
Practice Address - Country:US
Practice Address - Phone:740-522-8846
Practice Address - Fax:740-522-8846
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3509152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRU0501291Medicare ID - Type Unspecified