Healthcare Provider Details

I. General information

NPI: 1134125792
Provider Name (Legal Business Name): DONALD F RATCHFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 2ND ST
CRESSON PA
16630-1141
US

IV. Provider business mailing address

1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US

V. Phone/Fax

Practice location:
  • Phone: 814-886-2911
  • Fax: 814-886-8929
Mailing address:
  • Phone: 814-410-8300
  • Fax: 814-410-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD059696L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: