Provider Demographics
NPI:1982829560
Name:CARGIOLI, RON PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:PAUL
Last Name:CARGIOLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12987 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3864
Mailing Address - Country:US
Mailing Address - Phone:317-585-9410
Mailing Address - Fax:317-585-9411
Practice Address - Street 1:12987 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-3864
Practice Address - Country:US
Practice Address - Phone:317-585-9410
Practice Address - Fax:317-585-9411
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU13356Medicare ID - Type Unspecified