Provider Demographics
NPI:1740362938
Name:MANN, RONALD F (MD)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:F
Last Name:MANN
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:PO BOX 2667
Mailing Address - Street 2:9 FLORA STREET
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502
Mailing Address - Country:US
Mailing Address - Phone:606-432-4183
Mailing Address - Fax:606-432-4270
Practice Address - Street 1:9 FLORA STREET
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-432-4183
Practice Address - Fax:606-432-4270
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64199151Medicaid
KY0960701Medicare ID - Type Unspecified
KY64199151Medicaid