Healthcare Provider Details

I. General information

NPI: 1033590807
Provider Name (Legal Business Name): RYAN C. BIRKLAND D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5067 55TH ST NW
ROCHESTER MN
55901-3809
US

IV. Provider business mailing address

5067 55TH ST NW
ROCHESTER MN
55901-3809
US

V. Phone/Fax

Practice location:
  • Phone: 507-292-7070
  • Fax:
Mailing address:
  • Phone: 507-292-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberDO-05482
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number7436
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number80703
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: