Provider Demographics
NPI:1821269929
Name:RONALD A VIERK MD LLC
Entity Type:Organization
Organization Name:RONALD A VIERK MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:VIERK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-966-1195
Mailing Address - Street 1:1526 HUNTERS POINTE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-7924
Mailing Address - Country:US
Mailing Address - Phone:765-966-1195
Mailing Address - Fax:
Practice Address - Street 1:1900 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1213
Practice Address - Country:US
Practice Address - Phone:765-966-1945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031317B207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty