Provider Demographics
NPI:1912298399
Name:DUVALL, RONALD ROSS (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ROSS
Last Name:DUVALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1A GIBBENS LN
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1503
Mailing Address - Country:US
Mailing Address - Phone:740-423-0924
Mailing Address - Fax:
Practice Address - Street 1:1A GIBBENSLN
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1503
Practice Address - Country:US
Practice Address - Phone:740-423-0924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03108902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist