Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 52207 | TN |
NPI | 1487686598 |
---|---|
Provider Name | Dr. Mark Xavier Ransom |
First Address | Mountain Home, TN 37684-0699 |
Second Address | Johnson City, TN 37604-3799 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 25/03/2015 |