Provider Demographics
NPI:1841285442
Name:HULL, RONALD K (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:K
Last Name:HULL
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 1:1 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-8022
Mailing Address - Country:US
Mailing Address - Phone:406-461-8510
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8022
Practice Address - Country:US
Practice Address - Phone:406-457-8244
Practice Address - Fax:406-457-8236
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4154208VP0014X, 208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0107627Medicaid
MT000011290OtherBLUE CROSS
MT184821100OtherDEPARTMENT OF LABOR
MT00109215OtherMONTANA STATE FUND
MT000011290OtherBLUE CROSS
MT0107627Medicaid