Provider Demographics
NPI:1114047354
Name:MACY, RONALD C
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:MACY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1415
Mailing Address - Country:US
Mailing Address - Phone:513-398-9546
Mailing Address - Fax:775-854-2144
Practice Address - Street 1:1067 CHEROKEE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1415
Practice Address - Country:US
Practice Address - Phone:513-398-9546
Practice Address - Fax:775-854-2144
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver