Provider Demographics
NPI:1134222946
Name:RALPH, PAUL D (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:RALPH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 JOHN HARPER HWY
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-7463
Mailing Address - Country:US
Mailing Address - Phone:502-955-1449
Mailing Address - Fax:502-955-1471
Practice Address - Street 1:815 JOHN HARPER HWY
Practice Address - Street 2:SUITE 10
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7463
Practice Address - Country:US
Practice Address - Phone:502-955-1449
Practice Address - Fax:502-955-1471
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYV07894Medicare UPIN