Provider Demographics
NPI:1609107960
Name:CROW, RONALD MELTON (DO)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MELTON
Last Name:CROW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:701 PULASKI STREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-3926
Mailing Address - Country:US
Mailing Address - Phone:501-682-2645
Mailing Address - Fax:501-682-7553
Practice Address - Street 1:701 PULASKI STREET
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3926
Practice Address - Country:US
Practice Address - Phone:501-682-2645
Practice Address - Fax:501-682-7553
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC-5470207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC68109Medicare UPIN