Tate, Ricky Dean
Tate, Ricky Dean is an individual health care provider with primary practice located at 300 Carson St , Jonesboro AR 72401-3104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tate, Ricky Dean can be contacted via phone (870) 932-1198.Contact Information
Primary practice address
300 Carson St
Jonesboro AR 72401-3104
Phone: (870) 932-1198
Fax: (870) 910-7700
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | E2224 | Arkansas |
Profile Details
| NPI number | 1861488017 |
|---|---|
| LBN Legal business name | Tate, Ricky Dean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2005 |
| Last updated | Apr 28th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861488017 | NPPES |
| Arkansas | MEDICAID | 137536001 |
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