Provider Demographics
NPI:1356416044
Name:RONALD S. SPEIGLE, M.D. INC
Entity type:Organization
Organization Name:RONALD S. SPEIGLE, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SPEIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-246-1243
Mailing Address - Street 1:PO BOX 496084
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-6084
Mailing Address - Country:US
Mailing Address - Phone:530-241-0473
Mailing Address - Fax:530-241-5377
Practice Address - Street 1:1555 EAST ST
Practice Address - Street 2:STE 220
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1153
Practice Address - Country:US
Practice Address - Phone:530-246-1243
Practice Address - Fax:530-247-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30608208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC30608OtherSTATE LICENSE