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General NPI Number Information
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NPI Number | 1922107879
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Entity Type | Individual
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Provider Name | RONALD DEAN MINGS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 1001 E MAIN ST 2A PPE
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City | CARBONDALE
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State | IL
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Zip | 62901-3100
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Country | US
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Telephone | 618-549-9385
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Fax | 618-549-8795
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Provider Business Mailing Address
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Address Line | PO BOX 1105
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-1105
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Country | US
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Telephone | 618-549-9385
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Fax | 618-549-8795
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 036-050797
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License Number State | IL
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