Healthcare Provider Details

I. General information

NPI: 1629027222
Provider Name (Legal Business Name): RONNIE BOY BURNS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RONALD R SOLBERG DO

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E 2ND ST
DULUTH MN
55805-1913
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-8364
  • Fax:
Mailing address:
  • Phone: 218-786-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6685
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number6685
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number43247
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: