Individual
DR. RALPH WILLIAM TACK
Active
Individual
DR. RALPH WILLIAM TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MPH
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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