Provider Demographics
NPI:1467619254
Name:SEGURA, RONALD CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CHRISTOPHER
Last Name:SEGURA
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 1:141 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7513
Mailing Address - Country:US
Mailing Address - Phone:985-231-6751
Mailing Address - Fax:985-888-1838
Practice Address - Street 1:141 LAKEVIEW CIR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7513
Practice Address - Country:US
Practice Address - Phone:985-231-6751
Practice Address - Fax:985-888-1838
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200721208100000X, 2081P2900X
LAMD.200721208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1075221Medicaid
LA4N157Medicare PIN
LA1075221Medicaid