Individual
RONALD E NOLLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 S 5TH ST, ENID, OK 73701-5832
(580) 234-2878
Mailing address
720 W MAINE AVE, ENID, OK 73701-5414
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20457
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027580A
—
OK
01
—
P00324168
RR MEDICARE
OK
Enumeration date
05/26/2006
Last updated
10/23/2013
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