Provider Demographics
NPI:1215105622
Name:RAMSEY, MUKHTAR FREDERIC (LAC)
Entity type:Individual
Prefix:
First Name:MUKHTAR
Middle Name:FREDERIC
Last Name:RAMSEY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 N 32ND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3850
Mailing Address - Country:US
Mailing Address - Phone:602-996-8450
Mailing Address - Fax:602-996-8777
Practice Address - Street 1:10401 N 32ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3850
Practice Address - Country:US
Practice Address - Phone:602-996-8450
Practice Address - Fax:602-996-8777
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0605171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist