Basic Information
| Provider Information | |||||||||
| NPI: | 1205894425 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EMERICK | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13929 NW 166TH TER | ||||||||
| Address2: | |||||||||
| City: | ALACHUA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326158175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8505595989 | ||||||||
| FaxNumber: | 8508382140 | ||||||||
| Practice Location | |||||||||
| Address1: | 1702 S JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | PERRY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323485611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8505842141 | ||||||||
| FaxNumber: | 8508382140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 05/01/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | OS9746 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.