Provider Demographics
NPI:1437723327
Name:ANTHONY, RONALD JAMES JR
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JAMES
Last Name:ANTHONY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 ANTHONY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39739-5226
Mailing Address - Country:US
Mailing Address - Phone:662-364-2841
Mailing Address - Fax:
Practice Address - Street 1:90 ANTHONY RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:MS
Practice Address - Zip Code:39739-5226
Practice Address - Country:US
Practice Address - Phone:662-364-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver