Provider Demographics
NPI:1912924689
Name:KRINGLIE, ROSS A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:A
Last Name:KRINGLIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSS
Other - Middle Name:A
Other - Last Name:KRINGLIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1006 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3219
Mailing Address - Country:US
Mailing Address - Phone:406-586-8711
Mailing Address - Fax:406-587-2602
Practice Address - Street 1:1006 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3219
Practice Address - Country:US
Practice Address - Phone:406-586-8711
Practice Address - Fax:406-587-2602
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4017207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080013628Medicare PIN
D26041Medicare UPIN