Individual
MR. RONALD A BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRT, CRP
Contact information
Practice address
1215 WASHINGTON SQ, EVANSVILLE, IN 47715-6807
(812) 475-9520
Mailing address
966 N BAKER RD, BOONVILLE, IN 47601-9509
(812) 897-3211
(812) 897-5400
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
30001969A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30001969A
STATE LICENSE
IN
Enumeration date
11/13/2007
Last updated
11/13/2007
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