Provider Demographics
NPI:1730125766
Name:BROWNFIELD, RONALD LEE (DO)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:LEE
Last Name:BROWNFIELD
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:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25708-0390
Mailing Address - Country:US
Mailing Address - Phone:304-429-1088
Mailing Address - Fax:304-696-1623
Practice Address - Street 1:5170 US ROUTE 60 E
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2004
Practice Address - Country:US
Practice Address - Phone:304-429-5594
Practice Address - Fax:304-429-5627
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012804207Q00000X
WV1045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0900592Medicaid
080101851OtherRAILROAD MEDICARE
WV0040579000Medicaid
OH0900592Medicaid
WV0658718Medicare PIN