Provider Demographics
NPI:1992771356
Name:RAMPTON, MARK EDMOND (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:EDMOND
Last Name:RAMPTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 NW KINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330
Mailing Address - Country:US
Mailing Address - Phone:541-757-2400
Mailing Address - Fax:541-757-4719
Practice Address - Street 1:2400 NW KINGS BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330
Practice Address - Country:US
Practice Address - Phone:541-757-2400
Practice Address - Fax:541-757-4719
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR282103Medicaid
C93577Medicare UPIN
102299Medicare ID - Type Unspecified