Doctor Name: | JOANN G RYAN |
NPI Number: | 1457312399 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 2392 |
Business Practice Address: | 1727 S Cheyenne Ave Tulsa, OK - 741194661 |
Business Phone Number: | 9186455142 |
Business Fax Number: | |
Mailing Address: | 1727 S Cheyenne Ave, TULSA |
State: | OK |
Postal Code: | 741194661 |
Phone Number: | 9186455142 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2006 |
NPI Last Update Date: | 03/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2392 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |