Healthcare Provider Details

I. General information

NPI: 1427147636
Provider Name (Legal Business Name): THAD FRANKLIN RYALS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2016 STONEGATE TRL STE 100
VESTAVIA HLS AL
35242-2249
US

IV. Provider business mailing address

2016 STONEGATE TRL STE 100
VESTAVIA HLS AL
35242-2249
US

V. Phone/Fax

Practice location:
  • Phone: 205-901-8408
  • Fax: 205-728-1541
Mailing address:
  • Phone: 205-901-8408
  • Fax: 205-728-1541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number24384
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: