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Individual

RALPH N INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5111 ROGERS AVE, STE 40M, FORT SMITH, AR 72903-2047
(479) 709-7440
(479) 709-7441
Mailing address
PO BOX 1824, FORT SMITH, AR 72902-1824
(479) 709-7399
(479) 709-7053

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4289
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100073480A
OK
05
105589001
AR
Enumeration date
10/06/2005
Last updated
09/15/2008
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