Provider Demographics
NPI:1427019314
Name:ALLEY, RONALD E JR (DO)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:ALLEY
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 SW 9TH STREET
Mailing Address - Street 2:STE 6A
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-7666
Mailing Address - Country:US
Mailing Address - Phone:515-244-0700
Mailing Address - Fax:515-244-6139
Practice Address - Street 1:3300 SW 9TH STREET
Practice Address - Street 2:STE 6A
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-7666
Practice Address - Country:US
Practice Address - Phone:515-244-0700
Practice Address - Fax:515-244-6139
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01458208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0085951Medicaid
IA08595OtherBCBS
A54838Medicare UPIN
IA08595OtherBCBS