Provider Demographics
NPI:1710956867
Name:THIGPEN, RAMON LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:LEE
Last Name:THIGPEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-475-4500
Mailing Address - Fax:850-475-4619
Practice Address - Street 1:550 REDSTONE AVE W
Practice Address - Street 2:SUITE 200
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-6430
Practice Address - Country:US
Practice Address - Phone:850-682-6122
Practice Address - Fax:850-682-5917
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME46821207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041631200Medicaid
FL041631200Medicaid
FL46189ZMedicare ID - Type Unspecified