Individual
RONALD V DORN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N CURTIS ROAD, BOISE, ID 83706
(208) 367-3131
(208) 367-4860
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 367-3131
(208) 367-4860
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
M4653
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004085400
—
ID
Enumeration date
08/21/2006
Last updated
10/02/2017
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