Provider Demographics
NPI:1417190331
Name:RATSIMBASON, HARI MAHEFA (MD)
Entity Type:Individual
Prefix:DR
First Name:HARI MAHEFA
Middle Name:
Last Name:RATSIMBASON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 OLD RICEVILLE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-3074
Mailing Address - Country:US
Mailing Address - Phone:423-744-8755
Mailing Address - Fax:844-485-8911
Practice Address - Street 1:421 OLD RICEVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3074
Practice Address - Country:US
Practice Address - Phone:423-744-8755
Practice Address - Fax:844-485-8911
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD67693208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ082456Medicaid