Provider Demographics
NPI:1194860817
Name:OGARA, RONALD A (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:OGARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 E BARBARITA AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-8127
Mailing Address - Country:US
Mailing Address - Phone:480-833-7884
Mailing Address - Fax:
Practice Address - Street 1:2210 W SOUTHERN AVE # B-4
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4714
Practice Address - Country:US
Practice Address - Phone:480-833-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ60575Medicare ID - Type Unspecified
AZAZ0940640Medicare UPIN