Ralph Ford, MD
Individual provider Active NPI General Practice Physician · Salem, MO
NPI 1194704080 · NPPES record last updated Nov 6, 2009
Key facts
- NPI
- 1194704080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 252 30 (MO)
- Practice address
- 35629 Highway 72
Salem, MO 65560-7217 - Phone
- (573) 729-6626
- Fax
- (573) 729-6502
- NPI assigned
- Jan 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252 30 | MO | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Health Central Louisiana | Past | Accepting new patients | |
| Physician Groups LC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 252 30 | MO | Yes |
Addresses
Primary practice location
35629 Highway 72
Salem, MO 65560-7217
Mailing address
PO Box 774
35629 Highway 72
Salem, MO 65560-0774
Phone (573) 729-6626
Other providers in Salem, MO
- Enrichment Services of Dent County, Inc.
- Enrichment Services of Dent County, Inc.
- Faith Counseling, LLC
- Cori Nicole Farrar
- Brady Floyd
- Barbara C Fulton
- Jared Ganir
- Morris Scott Glover
- Brenda Gott
- Janet L Gott
All providers in Salem, MO · General Practice Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.