Provider Demographics
NPI:1972519775
Name:RALPH D MILLSAPS, MD, PC
Entity type:Organization
Organization Name:RALPH D MILLSAPS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLSAPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-437-4327
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47705-0717
Mailing Address - Country:US
Mailing Address - Phone:812-471-1591
Mailing Address - Fax:812-471-6650
Practice Address - Street 1:4405 BELLEMEADE AVE
Practice Address - Street 2:#102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0682
Practice Address - Country:US
Practice Address - Phone:812-437-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN235190Medicare ID - Type Unspecified