Individual
NATHAN RATCHFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 W 10TH ST, ROLLA, MO 65401
(573) 364-9000
(573) 202-2460
Mailing address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
2004016537
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11876195
CAQH PROVIDER #
—
05
—
1588874242
—
MO
01
—
431560263
TRICARE WEST
—
Enumeration date
05/23/2007
Last updated
04/25/2024
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