Provider Demographics
NPI:1174634737
Name:RAMSEY, RORY R (MD)
Entity Type:Individual
Prefix:
First Name:RORY
Middle Name:R
Last Name:RAMSEY
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 1:3340 EAST GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-302-2000
Mailing Address - Fax:208-302-2055
Practice Address - Street 1:1075 N. CURTIS ROAD
Practice Address - Street 2:STE. 200
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706
Practice Address - Country:US
Practice Address - Phone:208-302-2000
Practice Address - Fax:208-302-2055
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.086707207R00000X
IDM11159207R00000X
IDM-11159207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2675510Medicaid
RA4172303Medicare PIN