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1376523951

NPI Code Detail

MEDICARE: DR. RYAN DEAN FORD M.D.

MEDICARE: DR. RYAN DEAN FORD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	L5335	TX
2	207Q00000X	Family Medicine Physician	L5335	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	75-0818167-022	OTHER	TX	TRICARE
3	8A5545	OTHER	TX	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	8DC706	OTHER	TX	BCBS
7	75-1976930-005	OTHER	TX	TRICARE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	75-2616977-042	OTHER	TX	TRICARE

General Provider Information

NPI Number	:	1376523951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN DEAN FORD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 847522
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7522
Country	:	US
Telephone Number	:	903-531-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2026 S JACKSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-5822
Country	:	US
Telephone Number	:	903-541-4599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/22/2025

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Directions to “ DR. RYAN DEAN FORD M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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