Healthcare Provider Details

I. General information

NPI: 1649538471
Provider Name (Legal Business Name): RYAN PATRICK RICHARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5246 BRITTANY DR
BATON ROUGE LA
70808-4782
US

IV. Provider business mailing address

5246 BRITTANY DR
BATON ROUGE LA
70808-4782
US

V. Phone/Fax

Practice location:
  • Phone: 225-757-4091
  • Fax: 225-757-4093
Mailing address:
  • Phone: 225-757-4091
  • Fax: 225-757-4093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.206902
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number206902
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD.206902
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: