Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 4581 | AZ |
NPI | 1336208123 |
---|---|
Provider Name | Dr. Dale Thomas Ratcliffe |
First Address | Tucson, AZ 85712-7005 |
Second Address | Tucson, AZ 85712-7005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2006 |
Last Update Date | 28/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
177759 | (05) | AZ |
I38388 | (02) | AZ |