Provider Demographics
NPI:1750313151
Name:REICHEL, RONALD R (MD - PHD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:R
Last Name:REICHEL
Suffix:
Gender:M
Credentials:MD - PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1111 PACIFIC AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201
Practice Address - Country:US
Practice Address - Phone:425-257-1100
Practice Address - Fax:425-257-1106
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86094207RN0300X
LAMD.203487207RN0300X
WA60166663207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1810991Medicaid
MS00822049Medicaid
LA4M5696629Medicare PIN
LA1810991Medicaid