Tack, Ralph William

Tack, Ralph William is an individual health care provider with primary practice located at 715 S Taft Ave , Fremont OH 43420-3200. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine is his primary health care specialty. Tack, Ralph William can be contacted via phone (419) 333-2738.

Contact Information

Primary practice address
715 S Taft Ave Fremont OH 43420-3200
Phone: (419) 333-2738
Fax: (419) 333-6416
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine 2083P0500X 35048041 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35048041 Ohio

Profile Details

NPI number 1578620621
LBN Legal business name Tack, Ralph William
Credentials M.D., MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 1st, 2007
Last updated Mar 1st, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578620621 NPPES
Ohio Other 35048041 MEDICAL LICENSE

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