Provider Demographics
NPI:1679582894
Name:RAMAGE, JAY N (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:N
Last Name:RAMAGE
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 1:430 S LAKE ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4573
Mailing Address - Country:US
Mailing Address - Phone:731-642-3024
Mailing Address - Fax:731-642-3028
Practice Address - Street 1:430 S LAKE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4573
Practice Address - Country:US
Practice Address - Phone:731-642-3024
Practice Address - Fax:731-642-3028
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1516653Medicaid
TN103I085599Medicare PIN
I45634Medicare UPIN