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Individual

DR. RALPH B FILLMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1108 ROSS CLARK CIRCLE, DOTHAN, AL 36301
(334) 793-5105
Mailing address
1118 ROSS CLARK CIRCLE, STE 700 ANESTHESIA CONSULTANTS MEDICAL GROUP PC, DOTHAN, AL 36301
(334) 793-5105
(334) 671-5073

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
00014897
AL
207LP2900X
Pain Medicine (Anesthesiology) Physician
00014897
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00416336A
GA
01
51081478
BCBS OF ALABAMA
AL
Enumeration date
01/10/2006
Last updated
08/22/2007
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