Provider Demographics
NPI:1346261260
Name:LOUKS, RONALD W (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:W
Last Name:LOUKS
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 1:1313 SCHILLINGER RD S
Mailing Address - Street 2:APT 1401
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695
Mailing Address - Country:US
Mailing Address - Phone:251-753-4582
Mailing Address - Fax:
Practice Address - Street 1:6600 WALL ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4512
Practice Address - Country:US
Practice Address - Phone:251-662-4193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030686A207R00000X
IDM-10722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100107520EMedicaid
INB28851Medicare UPIN
IN100107520EMedicaid