Provider Demographics
NPI:1174672687
Name:RONIGER, RICHARD RAY (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RAY
Last Name:RONIGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 JACKSON AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5858
Mailing Address - Country:US
Mailing Address - Phone:504-565-5526
Mailing Address - Fax:504-565-5527
Practice Address - Street 1:1539 JACKSON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5858
Practice Address - Country:US
Practice Address - Phone:504-565-5526
Practice Address - Fax:504-565-5527
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD0108942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB61497Medicare UPIN
LA5L816CR33Medicare PIN