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General NPI Number Information
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NPI Number | 1497735039
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Entity Type | Individual
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Provider Name | RONNIE ALI DO
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 11564 STANTON CIR
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City | GULFPORT
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State | MS
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Zip | 39503-6156
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Country | US
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Telephone | 228-896-1016
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Fax | 228-354-0088
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Provider Business Mailing Address
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Address Line | 11564 STANTON CIR
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City | GULFPORT
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State | MS
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Zip | 39503-6156
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Country | US
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Telephone | 228-896-1016
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Fax | 228-354-0088
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS0009111
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 16596
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO0000001749
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License Number State | TN
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