Provider Demographics
NPI:1649380437
Name:KOURY, RONALD FORREST (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:FORREST
Last Name:KOURY
Suffix:
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 1:12955 LONGVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-2653
Mailing Address - Country:US
Mailing Address - Phone:904-703-5754
Mailing Address - Fax:904-880-7056
Practice Address - Street 1:8761 PERIMETER PARK BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1106
Practice Address - Country:US
Practice Address - Phone:904-641-6628
Practice Address - Fax:904-641-6638
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 8090207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine