Provider Demographics
NPI:1720081789
Name:RAMIREZ, RAUL RODRIGUEZ (MD)
Entity Type:Individual
Prefix:
First Name:RAUL
Middle Name:RODRIGUEZ
Last Name:RAMIREZ
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 1:606 W ARCH AVE
Mailing Address - Street 2:STE A
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5206
Mailing Address - Country:US
Mailing Address - Phone:501-279-0211
Mailing Address - Fax:501-279-0213
Practice Address - Street 1:606 W ARCH AVE
Practice Address - Street 2:STE. A
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5206
Practice Address - Country:US
Practice Address - Phone:501-279-0211
Practice Address - Fax:501-279-0213
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-10-04
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-21
Provider Licenses
StateLicense IDTaxonomies
ARR4544207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5J278Medicare PIN
ARC79393Medicare UPIN