Provider Demographics
NPI:1952032500
Name:RATLIFF, AUSTIN BLAKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:BLAKE
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4334 MARTHA BERRY HWY NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-8642
Mailing Address - Country:US
Mailing Address - Phone:706-235-1303
Mailing Address - Fax:706-235-8239
Practice Address - Street 1:4334 MARTHA BERRY HWY NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-8642
Practice Address - Country:US
Practice Address - Phone:706-235-1303
Practice Address - Fax:706-235-8239
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist