MEDICARE: THOMAS WARREN RATLIFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	31689	TN
2	207RH0003X	Hematology & Oncology Physician	14362	MS
3	207RH0003X	Hematology & Oncology Physician	E3185	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7366016	OTHER		AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	3127676	OTHER	TN	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	7157268	OTHER		CIGNA

General Provider Information

NPI Number	:	1639170665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS WARREN RATLIFF MD

Provider Business Mailing Address
First Line	:	7714 POPLAR AVE STE 200
Second Line	:	ATTN: CREDENTIALING
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-3941
Country	:	US
Telephone Number	:	901-683-0055
Fax Number	:	901-922-6722

Provider Business Practice Location Address
First Line	:	7945 WOLF RIVER BLVD
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-1762
Country	:	US
Telephone Number	:	901-683-0055
Fax Number	:	901-685-2969

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	04/04/2017

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Directions to “ THOMAS WARREN RATLIFF MD” Practice Location

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