MEDICARE: JON C RANSOM 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	174400000X	Specialist	MD00018272	WA
2	207R00000X	Internal Medicine Physician	MD00018272	WA
3	208M00000X	Hospitalist Physician	MD00018272	WA

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	263816	OTHER	WA	LABOR & INDUSTRIES

General Provider Information

NPI Number	:	1710982400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON C RANSOM MD

Provider Business Mailing Address
First Line	:	1400 E. KINCAID STREET
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4127
Country	:	US
Telephone Number	:	360-428-2500
Fax Number	:	360-428-6485

Provider Business Practice Location Address
First Line	:	1400 E. KINCAID STREET
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4127
Country	:	US
Telephone Number	:	360-416-5750
Fax Number	:	360-416-5758

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	11/30/2010

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Directions to “ JON C RANSOM MD” Practice Location

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