Provider Demographics
NPI:1942270061
Name:DAILEY, RONALD
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:DAILEY
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 1:5601 FOREST ISLE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-0000
Mailing Address - Country:US
Mailing Address - Phone:504-678-4609
Mailing Address - Fax:
Practice Address - Street 1:400 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70143-5077
Practice Address - Country:US
Practice Address - Phone:504-678-4609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman