Provider Demographics
NPI:1922107879
Name:MINGS, RONALD DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DEAN
Last Name:MINGS
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 1105
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1105
Mailing Address - Country:US
Mailing Address - Phone:618-549-9385
Mailing Address - Fax:618-549-8795
Practice Address - Street 1:1001 E MAIN ST
Practice Address - Street 2:2A PPE
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-3100
Practice Address - Country:US
Practice Address - Phone:618-549-9385
Practice Address - Fax:618-549-8795
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-050797207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL027533OtherHEALTH ALLIANCE
IL101269OtherHEALTHLINK
IL03927935OtherBLUE CROSS/ BLU SHIELD
IL03927935OtherBLUE CROSS/ BLU SHIELD
IL214881Medicare Oscar/Certification
C 43894Medicare UPIN
IL214881Medicare Oscar/Certification