Provider Demographics
NPI:1467544692
Name:MCCLESKEY, RALPH M (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:M
Last Name:MCCLESKEY
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 1:1201 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2932
Mailing Address - Country:US
Mailing Address - Phone:325-793-3100
Mailing Address - Fax:325-673-9223
Practice Address - Street 1:1201 N 18TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2932
Practice Address - Country:US
Practice Address - Phone:325-793-3100
Practice Address - Fax:325-673-9223
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6088207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060011938OtherRAILROAD MEDICARE
118938100OtherFIRSTCARE
TX125309801Medicaid
895003OtherBCBS
118938100OtherFIRSTCARE
895003Medicare ID - Type Unspecified
TX125309801Medicaid
TX060011938Medicare PIN