Miciak, Ronald F
Miciak, Ronald F is an individual health care provider with primary practice located at 801 Pole Line Rd W , Twin Falls ID 83301-5810. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Miciak, Ronald F can be contacted via phone (208) 814-4100.Contact Information
Primary practice address
801 Pole Line Rd W
Twin Falls ID 83301-5810
Phone: (208) 814-4100
Fax: (208) 814-4908
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | M4130 | Idaho |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | M4130 | Idaho |
Profile Details
| NPI number | 1235179052 |
|---|---|
| LBN Legal business name | Miciak, Ronald F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | May 3rd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235179052 | NPPES |
| Idaho | Other | P00029390 | RR MEDICARE |
| Idaho | MEDICAID | 002543700 | RR MEDICARE |
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