Provider Demographics
NPI:1669776050
Name:LITCHFIELD, RALPH VERLIN (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:VERLIN
Last Name:LITCHFIELD
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 1:21260 BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9602
Mailing Address - Country:US
Mailing Address - Phone:541-382-5016
Mailing Address - Fax:
Practice Address - Street 1:21260 BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9602
Practice Address - Country:US
Practice Address - Phone:541-382-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine