Basic Information
| Provider Information | |||||||||
| NPI: | 1154309763 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RATCHFORD | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | WHITE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17 WHITE ST | ||||||||
| Address2: | PO BOX 490 | ||||||||
| City: | CLEVELAND | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305281140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068654001 | ||||||||
| FaxNumber: | 7068656268 | ||||||||
| Practice Location | |||||||||
| Address1: | 17 WHITE ST | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305281140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068654001 | ||||||||
| FaxNumber: | 7068656268 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 12/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 12/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 45932 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 45932 | GA | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00889765A | 05 | GA | MEDICAID |