Provider Demographics
NPI:1699179655
Name:RAMER FAMILY HEALTH CENTER PLLC
Entity Type:Organization
Organization Name:RAMER FAMILY HEALTH CENTER PLLC
Other - Org Name:DR BARTON CHASE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARTON
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:731-645-6118
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:RAMER
Mailing Address - State:TN
Mailing Address - Zip Code:38367-0099
Mailing Address - Country:US
Mailing Address - Phone:731-645-6118
Mailing Address - Fax:731-645-8312
Practice Address - Street 1:3856 HIGHWAY 57 W
Practice Address - Street 2:
Practice Address - City:RAMER
Practice Address - State:TN
Practice Address - Zip Code:38367-7167
Practice Address - Country:US
Practice Address - Phone:731-645-6118
Practice Address - Fax:731-645-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000019117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3036385Medicaid
TN3036385Medicaid