Provider Demographics
NPI:1346284536
Name:RONNING, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:RONNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4801 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2099
Mailing Address - Country:US
Mailing Address - Phone:320-252-1670
Mailing Address - Fax:320-255-6359
Practice Address - Street 1:410 GOLD PASS HTS
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3882
Practice Address - Country:US
Practice Address - Phone:719-632-5700
Practice Address - Fax:719-579-9167
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2018-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN31507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN721002700Medicaid
MN089004132Medicare PIN
MN721002700Medicaid