Provider Demographics
NPI:1134108509
Name:DEUTSCH, RONALD ANTHONY (PA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ANTHONY
Last Name:DEUTSCH
Suffix:
Gender:M
Credentials:PA
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14505 LATROBE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-2614
Mailing Address - Country:US
Mailing Address - Phone:719-526-7489
Mailing Address - Fax:719-526-7181
Practice Address - Street 1:1650 COCHRANE CIR
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4603
Practice Address - Country:US
Practice Address - Phone:719-526-7489
Practice Address - Fax:719-526-7181
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO318363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical