MEDICARE: DR. EVERETT PERRY RAMSEY III M.D

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	207Q00000X	Family Medicine Physician	E4620	TX

General Provider Information

NPI Number	:	1457329039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVERETT PERRY RAMSEY III M.D

Provider Business Mailing Address
First Line	:	PO BOX 1129
Second Line	:
City	:	CROCKETT
State	:	TX
Zip	:	75835-1129
Country	:	US
Telephone Number	:	936-544-5132
Fax Number	:	936-544-3795

Provider Business Practice Location Address
First Line	:	1100 E LOOP 304
Second Line	:
City	:	CROCKETT
State	:	TX
Zip	:	75835-1810
Country	:	US
Telephone Number	:	936-544-5132
Fax Number	:	936-544-3795

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	07/08/2007

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