Individual
MR. RONALD L ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4060 N MAIN ST, RACINE, WI 53402-3121
(262) 752-2020
Mailing address
4060 N MAIN ST, RACINE, WI 53402-3121
(262) 752-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
26907-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014080001
ADMINASTAR-DMERC
WI
05
—
31447000
—
WI
Enumeration date
07/21/2005
Last updated
02/24/2009
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