Provider Demographics
NPI:1205967833
Name:KITTINGER, RONALD DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DEAN
Last Name:KITTINGER
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 1:7 HUDDLE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5367
Mailing Address - Country:US
Mailing Address - Phone:205-991-7304
Mailing Address - Fax:205-980-7280
Practice Address - Street 1:7 HUDDLE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5367
Practice Address - Country:US
Practice Address - Phone:205-991-7304
Practice Address - Fax:205-980-7280
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10578207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000097714OtherPTAN
ALC72480Medicare UPIN
AL000097714OtherPTAN