Doctor Name: | DR. RYAN K ANDERSON |
NPI Number: | 1053334730 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 282785-0501 |
Business Practice Address: | 596 W 750 S Suite 200 Bountiful, UT - 840107268 |
Business Phone Number: | 8012924425 |
Business Fax Number: | 8013971938 |
Mailing Address: | 596 W 750 S, Suite 200 BOUNTIFUL |
State: | UT |
Postal Code: | 840107268 |
Phone Number: | 8012924425 |
Fax Number: | 8013971938 |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 06/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 282785-0501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |