MEDICARE: DR. RALPH PARKS WARNOCK 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	017337	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080124926	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	619339	OTHER	GA	BLUSCROSS BLUESHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942295712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RALPH PARKS WARNOCK M.D.

Provider Business Mailing Address
First Line	:	1005 BOULDER DR
Second Line	:
City	:	GRAY
State	:	GA
Zip	:	31032-6141
Country	:	US
Telephone Number	:	478-621-2100
Fax Number	:	478-744-0481

Provider Business Practice Location Address
First Line	:	1005 BOULDER DR
Second Line	:
City	:	GRAY
State	:	GA
Zip	:	31032
Country	:	US
Telephone Number	:	478-621-2100
Fax Number	:	478-744-0481

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	03/07/2023

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