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General NPI Number Information
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NPI Number | 1891757878
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Entity Type | Individual
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Provider Name | RONALD JOSEPH KOLEGRAFF M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 1008 EASTVIEW AVE UNIT 8
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City | OKOBOJI
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State | IA
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Zip | 51355-2633
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Country | US
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Telephone | 712-332-6001
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Fax | 712-332-6010
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Provider Business Mailing Address
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Address Line | PO BOX 125
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City | OKOBOJI
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State | IA
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Zip | 51355-0125
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Country | US
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Telephone | 712-332-6001
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Fax | 712-332-6010
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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 | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 24582
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 24582
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License Number State | IA
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