Healthcare Provider Details

I. General information

NPI: 1992796361
Provider Name (Legal Business Name): JACK RANSOM INGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 LAKE BOONE TRL SUITE 300
RALEIGH NC
27607-7513
US

IV. Provider business mailing address

4414 LAKE BOONE TRL SUITE 300
RALEIGH NC
27607-7513
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-5510
  • Fax: 919-781-5053
Mailing address:
  • Phone: 919-781-5510
  • Fax: 919-781-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number9700990
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: