Provider Demographics
NPI:1275007239
Name:AYERS, RONALD G (LICENSED CONTRACTOR)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:AYERS
Suffix:
Gender:M
Credentials:LICENSED CONTRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9883 CRUSADER DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1613
Mailing Address - Country:US
Mailing Address - Phone:513-375-2450
Mailing Address - Fax:
Practice Address - Street 1:9883 CRUSADER DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1613
Practice Address - Country:US
Practice Address - Phone:513-375-2450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH27170171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor