Provider Demographics
NPI:1629117247
Name:RITZ, RONALD G (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:G
Last Name:RITZ
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 1:575 RIVERGATE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7487
Mailing Address - Country:US
Mailing Address - Phone:970-259-5990
Mailing Address - Fax:970-259-5934
Practice Address - Street 1:575 RIVERGATE
Practice Address - Street 2:SUITE 205
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7487
Practice Address - Country:US
Practice Address - Phone:970-259-5990
Practice Address - Fax:970-259-5934
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32365174400000X, 208200000X, 2082S0105X, 2086S0122X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01323658Medicaid
CO01323658Medicaid