Provider Demographics
NPI:1225359144
Name:AYCOCK, RONALD L JR (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:AYCOCK
Suffix:JR
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 1:608 NW 9TH ST STE 6210
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1069
Mailing Address - Country:US
Mailing Address - Phone:405-272-9641
Mailing Address - Fax:405-235-0738
Practice Address - Street 1:1000 N LEE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1036
Practice Address - Country:US
Practice Address - Phone:405-272-8000
Practice Address - Fax:405-235-0738
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8643207L00000X
OK27950207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology