Provider Demographics
NPI:1043240989
Name:OLDROYD, RONALD I (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:I
Last Name:OLDROYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N 300 W STE 316
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3373
Mailing Address - Country:US
Mailing Address - Phone:801-357-7530
Mailing Address - Fax:801-357-7566
Practice Address - Street 1:1055 N 300 W STE 316
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3373
Practice Address - Country:US
Practice Address - Phone:801-357-7530
Practice Address - Fax:801-357-7566
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT162420-1205208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000059625Medicare ID - Type Unspecified
UTC63927Medicare UPIN