Provider Demographics
NPI:1659369841
Name:HRATKO, JOHN RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RALPH
Last Name:HRATKO
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 1:207 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-1444
Mailing Address - Country:US
Mailing Address - Phone:610-746-2061
Mailing Address - Fax:610-365-8636
Practice Address - Street 1:207 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-1444
Practice Address - Country:US
Practice Address - Phone:610-746-2061
Practice Address - Fax:610-365-8636
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA037569-E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
672920OtherSENIOR BLUE
160035967OtherRAILROAD MEDICARE
01046501OtherCAPITAL BLUE CROSS
050619400OtherKEYSTONE HEALTH PLAN EAST
1520361OtherGATEWAY
PA672920OtherMEDICARE/CMS
1136059/05OtherMEDICAL ASSITANCE/ACCESS
5052165OtherAETNA US HEALTHCARE
9084429001OtherCIGNA
PA0018878060001Medicaid
050619400OtherPERSONAL CHOICE
672920OtherHIGHMARK
672920OtherKEYSTONE HEALTHPLAN CENTR
5052165OtherAETNA US HEALTHCARE