Individual
RONALD M. EIMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 CIMARRON DRIVE, MANNFORD, OK 74044-0323
(918) 865-5000
(918) 865-5050
Mailing address
2401 SOUTHWEST BLVD, TULSA, OK 74107-2726
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2520
OK
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
2520
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100129700A
—
OK
01
—
857981
MEDICARE
OK
Enumeration date
09/29/2006
Last updated
05/13/2020
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