Provider Demographics
NPI:1548264450
Name:RALPH, ASPEN I (DO)
Entity type:Individual
Prefix:
First Name:ASPEN
Middle Name:I
Last Name:RALPH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6060 N FOUNTAIN PLAZA DR STE 270
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7873
Mailing Address - Country:US
Mailing Address - Phone:520-229-2578
Mailing Address - Fax:520-229-2561
Practice Address - Street 1:6060 N FOUNTAIN PLAZA DR STE 270
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7873
Practice Address - Country:US
Practice Address - Phone:520-229-2578
Practice Address - Fax:520-229-2561
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ2Z1203OtherHEALTH NET
AZAZ0758740OtherBLUE CROSS BLUE SHIELD
AZ3122834OtherAETNA HEALTHCARE
AZ860750942OtherARIZONA FOUNDATION
AZ0402296OtherUNITED HEALTHCARE
AZ2192402OtherFIRST HEALTH
AZ8671843002OtherCIGNA HEALTHCARE
AZ84750Medicare PIN
AZ2Z1203OtherHEALTH NET
AZ3122834OtherAETNA HEALTHCARE
AZ26734Medicare PIN