Ryan, Keith T
Ryan, Keith T is an sole proprietor health care provider with primary practice located at 107 E Oak Ave Suite 202, Flagstaff AZ 86001-1818. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ryan, Keith T can be contacted via phone (928) 213-8633.Contact Information
Primary practice address
107 E Oak Ave Suite 202
Flagstaff AZ 86001-1818
Phone: (928) 213-8633
Fax: (928) 213-8634
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 22530 | Arizona |
Profile Details
| NPI number | 1366416869 |
|---|---|
| LBN Legal business name | Ryan, Keith T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Mar 1st, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366416869 | NPPES |
| Arizona | MEDICAID | 167339 |
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