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Individual

MR. CURTIS RAY PONDER II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RO,ABOC

Contact information

Practice address
200 TOLL GATE RD, WARWICK, RI 02886-4440
(401) 737-2020
Mailing address
12 WILLOW RD, CRANSTON, RI 02920-2626
(401) 737-2020

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OP308
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21-01254
UNITED HEALTH
RI
01
27367-1
BLUE CROSS
RI
01
29681
NEIGHBORHOOD HEALTH
RI
01
411619
BLUE CHIP
RI
05
CP54036
RI
Enumeration date
10/03/2006
Last updated
04/07/2021
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