Provider Demographics
NPI:1164862405
Name:RINGO, PRESTON D (DPM)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:D
Last Name:RINGO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 BATH RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2771
Mailing Address - Country:US
Mailing Address - Phone:207-725-4008
Mailing Address - Fax:207-725-5749
Practice Address - Street 1:66 CHAPMAN ST
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4614
Practice Address - Country:US
Practice Address - Phone:207-563-3233
Practice Address - Fax:207-563-3201
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD1102213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty