Provider Demographics
NPI:1184048795
Name:RALPH, TARA (DO)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:RALPH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TARA
Other - Middle Name:GANSHEIMER
Other - Last Name:RALPH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1272 GARRISON DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2598
Mailing Address - Country:US
Mailing Address - Phone:615-867-8010
Mailing Address - Fax:615-867-7955
Practice Address - Street 1:1272 GARRISON DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2598
Practice Address - Country:US
Practice Address - Phone:615-867-8010
Practice Address - Fax:615-867-7955
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10041300-559448207R00000X
TN2606207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine