Provider Demographics
NPI:1720390578
Name:BOMB, RITIN (MD)
Entity Type:Individual
Prefix:
First Name:RITIN
Middle Name:
Last Name:BOMB
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:PO BOX 691
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-0691
Mailing Address - Country:US
Mailing Address - Phone:901-979-4140
Mailing Address - Fax:901-979-8151
Practice Address - Street 1:995 S YATES RD STE 2
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0882
Practice Address - Country:US
Practice Address - Phone:901-979-4140
Practice Address - Fax:901-979-8151
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54823207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease