Provider Demographics
NPI:1366445421
Name:CALDWELL, RONALD G (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:G
Last Name:CALDWELL
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 1:413 E JEFFERSON BLVD
Mailing Address - Street 2:MATTHEW 25 HEALTH AND DENTAL CLINIC
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-3201
Mailing Address - Country:US
Mailing Address - Phone:260-426-3250
Mailing Address - Fax:260-426-0443
Practice Address - Street 1:413 E JEFFERSON BLVD
Practice Address - Street 2:MATTHEW 25 HEALTH AND DENTAL CLINIC
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-3201
Practice Address - Country:US
Practice Address - Phone:260-426-3250
Practice Address - Fax:260-426-0443
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027738A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery