Provider Demographics
NPI:1851315733
Name:SMITS, RONALD L (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:SMITS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6233 BANKERS RD
Mailing Address - Street 2:STE 3
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53403-9700
Mailing Address - Country:US
Mailing Address - Phone:262-898-4400
Mailing Address - Fax:262-898-4423
Practice Address - Street 1:6233 BANKERS RD
Practice Address - Street 2:STE 3
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53403-9700
Practice Address - Country:US
Practice Address - Phone:262-898-4400
Practice Address - Fax:262-898-4423
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-08-13
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Provider Licenses
StateLicense IDTaxonomies
WI17488-020207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A87644Medicare UPIN