Provider Demographics
NPI:1659125177
Name:RANSAW, EVETTE (BS, MS, DDS)
Entity Type:Individual
Prefix:DR
First Name:EVETTE
Middle Name:
Last Name:RANSAW
Suffix:
Gender:F
Credentials:BS, MS, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4144
Mailing Address - Country:US
Mailing Address - Phone:334-324-2819
Mailing Address - Fax:
Practice Address - Street 1:3732 US HIGHWAY 431 N
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-2362
Practice Address - Country:US
Practice Address - Phone:334-408-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program