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NPI Code Detail

MEDICARE: MARK J RATCHFORD DO

MEDICARE:   MARK J RATCHFORD  DO
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
1207Q00000XFamily Medicine PhysicianOS011062LPA

General Provider Information

NPI Number : 1669479101
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK J RATCHFORD DO
Provider Business Mailing Address
First Line : 1086 FRANKLIN ST
Second Line :
City : JOHNSTOWN
State : PA
Zip : 15905-4305
Country : US
Telephone Number : 814-410-8300
Fax Number : 814-410-8331
Provider Business Practice Location Address
First Line : 3670 PORTAGE ST
Second Line :
City : PORTAGE
State : PA
Zip : 15946-6546
Country : US
Telephone Number : 814-736-9614
Fax Number : 814-736-9783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 10/20/2014

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Directions to “ MARK J RATCHFORD DO” Practice Location

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