Provider Demographics
NPI:1235328311
Name:MCELVAIN, RONALD E (OD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:E
Last Name:MCELVAIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25970
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80936-5970
Mailing Address - Country:US
Mailing Address - Phone:719-330-8772
Mailing Address - Fax:719-591-1358
Practice Address - Street 1:423 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-6246
Practice Address - Country:US
Practice Address - Phone:719-471-7347
Practice Address - Fax:719-471-7340
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist