Healthcare Provider Details
I. General information
NPI: 1598864662
Provider Name (Legal Business Name): RYAN GEDDES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2951 MAPLE AVE
ZANESVILLE OH
43701-1406
US
IV. Provider business mailing address
2951 MAPLE AVE
ZANESVILLE OH
43701-1406
US
V. Phone/Fax
- Phone: 513-281-4400
- Fax: 513-587-8213
- Phone: 513-281-4400
- Fax: 513-587-8213
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 34008704 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: