Provider Demographics
NPI:1740470210
Name:RATLIFF, CARL T (DO)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:T
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17160 DRAGONFLY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3634
Mailing Address - Country:US
Mailing Address - Phone:765-752-2242
Mailing Address - Fax:765-422-5806
Practice Address - Street 1:17160 DRAGONFLY DR STE 300
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3634
Practice Address - Country:US
Practice Address - Phone:765-252-2242
Practice Address - Fax:765-422-5806
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004483A2084P0804X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201246540Medicaid
ININ2504014Medicare PIN