Organization
DR RONN MCDANIEL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONN MCDANIEL OD (OWNER)
(320) 839-3413
Entity
Organization
Contact information
Practice address
128 2ND ST NW, ORTONVILLE, MN 56278-1409
(320) 839-3413
Mailing address
1200 E 25TH ST, HIBBING, MN 55746-3897
(320) 839-3413
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2619
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121080
UCARE
MN
01
—
2212701
MEDICA
MN
01
—
5C856MC
BLUE CROSS BLUE SHIELD
MN
01
—
5C859MC
BLUE CROSS BLUE SHIELD
MN
05
—
848152100
—
MN
05
—
9200830
—
SD
01
—
DP3657
RAIL ROAD MEDICARE
MN
01
—
S42523
NORIDIAN
SD
Enumeration date
01/17/2007
Last updated
06/11/2012
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