Provider Demographics
NPI:1821013376
Name:RINGSRED, ERIC JOHN
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JOHN
Last Name:RINGSRED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 COURT AVE S
Mailing Address - Street 2:
Mailing Address - City:SANDSTONE
Mailing Address - State:MN
Mailing Address - Zip Code:55072-5120
Mailing Address - Country:US
Mailing Address - Phone:320-245-2211
Mailing Address - Fax:
Practice Address - Street 1:109 COURT AVE S
Practice Address - Street 2:
Practice Address - City:SANDSTONE
Practice Address - State:MN
Practice Address - Zip Code:55072-5120
Practice Address - Country:US
Practice Address - Phone:320-245-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24374207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30247700Medicaid
D48917Medicare UPIN