Basic Information
| Provider Information | |||||||||
| NPI: | 1386647212 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIGLER | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 LEWISTON ST | ||||||||
| Address2: | |||||||||
| City: | COTTONWOOD | ||||||||
| State: | ID | ||||||||
| PostalCode: | 835229750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2089623267 | ||||||||
| FaxNumber: | 2089622313 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 LEWISTON ST | ||||||||
| Address2: | |||||||||
| City: | COTTONWOOD | ||||||||
| State: | ID | ||||||||
| PostalCode: | 835229750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2089623267 | ||||||||
| FaxNumber: | 2089622313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 04/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | M4841 | ID | N | Allopathic & Osteopathic Physicians | Surgery | 207Q00000X | M4841 | ID | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 002284300 | 05 | ID | MEDICAID |