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General NPI Number Information
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NPI Number | 1760602361
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Entity Type | Organization
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Legal Business Name | RONALD E. JAMERSON, M.D.,P.C.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24 JOLIET ST SUTIE 301
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City | DYER
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State | IN
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Zip | 46311-1705
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Country | US
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Telephone | 219-322-7462
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Fax | 219-322-8347
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Provider Business Mailing Address
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Address Line | 24 JOLIET ST SUTIE 301
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City | DYER
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State | IN
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Zip | 46311-1705
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Country | US
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Telephone | 219-322-7462
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Fax | 219-322-8347
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Authorized Official
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Title or Position | C.E.O
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Name | DR. RONALD EUGENE JAMERSON
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Credential | M.D.
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Telephone | 219-322-7462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 01039372
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License Number State | IN
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