# KEITH M RAMSEY MEDICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609866722
- **Authorized official:** MR. ORVILLE C ROSE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (904) 503-1132

## Contact information

- **Practice address:** 7863 BROADWAY STE 244, MERRILLVILLE, IN 46410-5553
- **Practice address phone:** (773) 991-3602
- **Practice address fax:** (219) 962-5053
- **Mailing address:** 1512 BURR ST, GARY, IN 46406-2369
- **Mailing address phone:** (219) 944-3933
- **Mailing address fax:** (219) 944-2473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 01036485 | IN | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | 036068254 | IL | — |

## Other

- **Enumeration date:** 10/28/2005
- **Last updated:** 02/20/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100201350A | — | IN |