Provider Demographics
NPI:1962778308
Name:RUTH, LEIGH JOANNE WARD (MD)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:JOANNE WARD
Last Name:RUTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEIGH
Other - Middle Name:JOANNE
Other - Last Name:RUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:813-974-2201
Mailing Address - Fax:
Practice Address - Street 1:3515 E FLETCHER AVE # MDC14
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4706
Practice Address - Country:US
Practice Address - Phone:813-974-4657
Practice Address - Fax:813-974-3236
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1322742084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021751200Medicaid
FL0R6TMOtherBLUE CROSS BLUE SHIELD