Individual
DR. RALPH WILLIAM TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MPH
Contact information
Practice address
715 S TAFT AVE, FREMONT, OH 43420-3200
(419) 333-2738
(419) 333-6416
Mailing address
715 S TAFT AVE, FREMONT, OH 43420-3200
(419) 333-2738
(419) 333-6416
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35048041
OH
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
35048041
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35048041
MEDICAL LICENSE
OH
Enumeration date
01/01/2007
Last updated
03/01/2010
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