MEDICARE: DR. PAUL MCCAFFERTY RYAN MD

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	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	21229	NV
2	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	C172740	CA
3	207X00000X	Orthopaedic Surgery Physician	C172740	CA

General Provider Information

NPI Number	:	1770555393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL MCCAFFERTY RYAN MD

Provider Business Mailing Address
First Line	:	PO BOX 1143
Second Line	:
City	:	ZEPHYR COVE
State	:	NV
Zip	:	89448-1143
Country	:	US
Telephone Number	:	530-543-5668
Fax Number	:

Provider Business Practice Location Address
First Line	:	935 MICA DR
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89705-7268
Country	:	US
Telephone Number	:	775-783-3082
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	04/14/2022

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