Provider Demographics
NPI:1083169718
Name:HIXON, RUTH ANGELA (RPH)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:ANGELA
Last Name:HIXON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 CANTERBURY RD NE APT 917
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-1900
Mailing Address - Country:US
Mailing Address - Phone:954-290-9797
Mailing Address - Fax:
Practice Address - Street 1:925 CANTERBURY RD NE APT 917
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-1900
Practice Address - Country:US
Practice Address - Phone:954-290-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027754183500000X
FLPS44205183500000X
SCPH35911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist