Individual
RONALD ARTHUR BACKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4185 W LAKE ELWOOD RD, FLORENCE, WI 54121-9158
(715) 696-6416
Mailing address
4185 W LAKE ELWOOD RD, FLORENCE, WI 54121-9158
(715) 696-6416
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301028031
MI
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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