Provider Demographics
NPI:1467567115
Name:ASPEN RALPH DO PLLC
Entity Type:Organization
Organization Name:ASPEN RALPH DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASPEN
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:RALPH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-229-1506
Mailing Address - Street 1:2001 W ORANGE GROVE RD
Mailing Address - Street 2:#308
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1139
Mailing Address - Country:US
Mailing Address - Phone:520-229-1506
Mailing Address - Fax:520-229-1549
Practice Address - Street 1:2001 W ORANGE GROVE RD
Practice Address - Street 2:#308
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1139
Practice Address - Country:US
Practice Address - Phone:520-229-1506
Practice Address - Fax:520-229-1549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ110308Medicare PIN
AZZ110307Medicare PIN
AZH65291Medicare UPIN
AZ1548264450OtherNPI
AZZ110308Medicare PIN