Provider Demographics
NPI:1417989732
Name:BARTH, RONALD J (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:BARTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 E DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1013
Mailing Address - Country:US
Mailing Address - Phone:316-685-9641
Mailing Address - Fax:316-685-0820
Practice Address - Street 1:4825 E DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1013
Practice Address - Country:US
Practice Address - Phone:316-685-9641
Practice Address - Fax:316-685-0820
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS007197OtherBLUE CROSS & BLUE SHIELD
KS007197Medicare ID - Type Unspecified
KS007197OtherBLUE CROSS & BLUE SHIELD