Provider Demographics
NPI:1740479450
Name:RALPH I. TOUMA, M. D., P. S. C
Entity type:Organization
Organization Name:RALPH I. TOUMA, M. D., P. S. C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:I
Authorized Official - Last Name:TOUMA
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:606-325-4697
Mailing Address - Street 1:PO BOX 1588
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1588
Mailing Address - Country:US
Mailing Address - Phone:606-325-4697
Mailing Address - Fax:606-326-0108
Practice Address - Street 1:330 21ST ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7726
Practice Address - Country:US
Practice Address - Phone:606-325-4697
Practice Address - Fax:606-326-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18218207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65906752Medicaid
OH0284268Medicaid
KY0685Medicare PIN
KYC69723Medicare UPIN