Provider Demographics
NPI:1902896467
Name:DEAS, RALPH H (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:H
Last Name:DEAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1131 STRINGER RIDGE RD
Mailing Address - Street 2:UNIT 8 J
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-3255
Mailing Address - Country:US
Mailing Address - Phone:423-752-3061
Mailing Address - Fax:706-861-7810
Practice Address - Street 1:1281 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4009
Practice Address - Country:US
Practice Address - Phone:706-861-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA008418207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA18BDFVVMedicare ID - Type Unspecified
GAE59013Medicare UPIN
GA18BDFVWMedicare ID - Type UnspecifiedMEDICARE MADISON