Doctor Name: | DR. DAVID L RYAN |
NPI Number: | 1013908052 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 32427 |
Business Practice Address: | 902 Custer St Trenton, MO - 646832238 |
Business Phone Number: | 6603594317 |
Business Fax Number: | 6603594993 |
Mailing Address: | 902 Custer St, TRENTON |
State: | MO |
Postal Code: | 646832238 |
Phone Number: | 6603594317 |
Fax Number: | 6603594993 |
NPI Enumeration Date: | 10/31/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | 32427 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |