Provider Demographics
NPI:1316029333
Name:SALIK, RONALD MANNON (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MANNON
Last Name:SALIK
Suffix:
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 1:630 N ALVERNON WAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1843
Mailing Address - Country:US
Mailing Address - Phone:520-647-8854
Mailing Address - Fax:520-647-8851
Practice Address - Street 1:630 N ALVERNON WAY
Practice Address - Street 2:SUITE 250
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1843
Practice Address - Country:US
Practice Address - Phone:520-647-8854
Practice Address - Fax:520-647-8851
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25392207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ384404Medicaid
930128760OtherRAILROAD MCR
AZ384404OtherAHCCCS
AZ384404Medicaid
AZ384404OtherAHCCCS