Provider Demographics
NPI:1104823772
Name:EARP, RALPH THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:THOMAS
Last Name:EARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MEMORIAL BLVD
Mailing Address - Street 2:AQUIDNECK MEDICAL ASSOCIATES
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-3587
Mailing Address - Country:US
Mailing Address - Phone:401-847-2290
Mailing Address - Fax:401-849-8446
Practice Address - Street 1:50 MEMORIAL BLVD
Practice Address - Street 2:AQUIDNECK MEDICAL ASSOCIATES
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-3587
Practice Address - Country:US
Practice Address - Phone:401-847-2290
Practice Address - Fax:401-849-8446
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9002090Medicaid
RI9002090Medicaid
RIC89717Medicare UPIN