Provider Demographics
NPI:1760580211
Name:RONALD E ARRICK M D INC
Entity Type:Organization
Organization Name:RONALD E ARRICK M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-354-8837
Mailing Address - Street 1:1729 KINNEYS LANE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3167
Mailing Address - Country:US
Mailing Address - Phone:740-354-8837
Mailing Address - Fax:740-353-7943
Practice Address - Street 1:1611 27TH ST STE 103 BLDG J
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3167
Practice Address - Country:US
Practice Address - Phone:740-354-8837
Practice Address - Fax:740-353-7943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207R00000X
OH35042736207R00000X
OH34006652207R00000X
OH09051NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2766458Medicaid
OH0429227Medicaid
OH110155403OtherTRAVELERS MEDICARE
OH2020851Medicaid
OH793111263OtherTRAVELERS MEDICARE
OH0429227Medicaid
OH2766458Medicaid
OH0829761Medicare PIN
OH793111263OtherTRAVELERS MEDICARE
OHA14969Medicare UPIN
0475262Medicare PIN