Provider Demographics
NPI:1174592133
Name:HOLWEGER, RONALD RAY (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:RAY
Last Name:HOLWEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 CANTERBURY DRIVE
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2233
Mailing Address - Country:US
Mailing Address - Phone:785-625-4363
Mailing Address - Fax:785-625-4894
Practice Address - Street 1:2503 CANTERBURY DRIVE
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2233
Practice Address - Country:US
Practice Address - Phone:785-625-4363
Practice Address - Fax:785-625-4894
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0420913207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS180023050OtherRR MEDICARE
KS021114OtherBCBS
KS100204640AMedicaid
KS021114Medicare PIN
KS021114OtherBCBS