Healthcare Provider Details

I. General information

NPI: 1760580211
Provider Name (Legal Business Name): RONALD E ARRICK M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 27TH ST STE 103 BLDG J
PORTSMOUTH OH
45662-3167
US

IV. Provider business mailing address

1729 KINNEYS LANE SUITE 202
PORTSMOUTH OH
45662-3167
US

V. Phone/Fax

Practice location:
  • Phone: 740-354-8837
  • Fax: 740-353-7943
Mailing address:
  • Phone: 740-354-8837
  • Fax: 740-353-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34006652
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number09051NP
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35042736
License Number StateOH

VIII. Authorized Official

Name: RONALD E ARRICK
Title or Position: MD PRESIDENT
Credential: MD
Phone: 740-354-8837