Healthcare Provider Details

I. General information

NPI: 1649319054
Provider Name (Legal Business Name): RYAN FLAMION MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N MERIDIAN STREET
HOLLAND IN
47541
US

IV. Provider business mailing address

PO BOX 1028
JASPER IN
47547-1028
US

V. Phone/Fax

Practice location:
  • Phone: 812-536-3943
  • Fax: 812-536-3222
Mailing address:
  • Phone: 812-481-8493
  • Fax: 812-481-8497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR1142
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01065030A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: