Provider Demographics
NPI:1003845215
Name:ROBERT R. RATCLIFFE
Entity type:Organization
Organization Name:ROBERT R. RATCLIFFE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:RATCLIFFE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:828-859-0307
Mailing Address - Street 1:574 HOWARD GAP RD
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-7610
Mailing Address - Country:US
Mailing Address - Phone:828-859-0307
Mailing Address - Fax:828-859-9260
Practice Address - Street 1:574 HOWARD GAP RD
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-7610
Practice Address - Country:US
Practice Address - Phone:828-859-0307
Practice Address - Fax:828-859-9260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC161522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC70514OtherBLUE CROSS BLUE SHIELD
NC891006GMedicaid
NC8970514Medicaid
NC891006GMedicaid
NCC80605Medicare UPIN
NC2333898Medicare ID - Type Unspecified