Provider Demographics
NPI:1407957996
Name:RAMEY, JACK M (DO)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:M
Last Name:RAMEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 COLEGATE DR BLDG 3
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-9549
Mailing Address - Country:US
Mailing Address - Phone:740-568-4814
Mailing Address - Fax:740-374-3165
Practice Address - Street 1:26 E PARK DR STE 105B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-5003
Practice Address - Country:US
Practice Address - Phone:740-331-6912
Practice Address - Fax:740-331-6913
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.003437207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0991600Medicaid
OHP00725188OtherRAILROAD MEDICARE
OHP00725188OtherRAILROAD MEDICARE
OHE26164Medicare UPIN