Provider Demographics
NPI:1114971801
Name:RAUL R RAMIREZ, MD, PA
Entity Type:Organization
Organization Name:RAUL R RAMIREZ, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-279-0211
Mailing Address - Street 1:606 WEST ARCH AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7323
Mailing Address - Country:US
Mailing Address - Phone:501-279-0211
Mailing Address - Fax:501-279-0213
Practice Address - Street 1:606 WEST ARCH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7323
Practice Address - Country:US
Practice Address - Phone:501-279-0211
Practice Address - Fax:501-279-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-4544174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C840Medicare PIN
ARC79393Medicare UPIN