Provider Demographics
NPI:1871632422
Name:RINGEN, ORAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:ORAN
Middle Name:J
Last Name:RINGEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2580
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-2580
Mailing Address - Country:US
Mailing Address - Phone:417-829-4620
Mailing Address - Fax:
Practice Address - Street 1:2212 W KEARNEY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-2029
Practice Address - Country:US
Practice Address - Phone:417-831-8074
Practice Address - Fax:417-864-6585
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7C44207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO24588OtherMO BLUE SHIELD
AR99037OtherARK BLUE SHIELD
AR140581001Medicaid
MO201494952Medicaid
AR140581001Medicaid
A14020Medicare UPIN