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Individual

RONALD LESLIE RENNICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1232 UNIVERSITY OF OREGON, EUGENE, OR 97403-1232
(541) 346-0565
(541) 346-2748
Mailing address
1232 UNIVERSITY OF OREGON, EUGENE, OR 97403-1205
(541) 346-0565
(541) 346-2748

Taxonomy

Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
10449
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
217562
OR
01
930026495
RAILROAD MEDICARE
OR
Enumeration date
01/27/2006
Last updated
12/11/2012
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