Provider Demographics
NPI:1750376703
Name:JOHNS, RONALD W (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:W
Last Name:JOHNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:608 GATEWAY CENTRAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-6354
Mailing Address - Country:US
Mailing Address - Phone:830-693-2005
Mailing Address - Fax:830-798-2006
Practice Address - Street 1:608 GATEWAY CENTRAL
Practice Address - Street 2:SUITE 100
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-6354
Practice Address - Country:US
Practice Address - Phone:830-693-2005
Practice Address - Fax:830-798-2006
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6507208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
8L22716Medicare PIN
TXG37877Medicare UPIN