Individual
MR. RONALD J JUENEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
655 5TH STREET, PHILLIPSBURG, KS 67661
(785) 543-2715
(785) 543-6556
Mailing address
PO BOX 509, PHILLIPSBURG, KS 67661
(785) 543-2715
(785) 543-6556
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13993
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0623020001
MEDICARE DMERC
KS
05
—
100219890B
—
KS
Enumeration date
09/20/2006
Last updated
10/25/2011
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