Provider Demographics
NPI:1104871243
Name:POLLARD, RONNIE A (MD)
Entity type:Individual
Prefix:
First Name:RONNIE
Middle Name:A
Last Name:POLLARD
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 OAK LAWN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4349
Mailing Address - Country:US
Mailing Address - Phone:972-709-1961
Mailing Address - Fax:
Practice Address - Street 1:16478 US HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-8598
Practice Address - Country:US
Practice Address - Phone:251-965-2145
Practice Address - Fax:251-965-2149
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ51162084P0800X
AL205412084P0800X
ALMD.205412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000051228Medicaid
AL51228OtherBCBS
G30101Medicare UPIN
AL000051228Medicaid