Healthcare Provider Details

I. General information

NPI: 1316391949
Provider Name (Legal Business Name): DANIEL RYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 20TH ST STE 505
KNOXVILLE TN
37916-1869
US

IV. Provider business mailing address

501 20TH ST STE 505
KNOXVILLE TN
37916-1869
US

V. Phone/Fax

Practice location:
  • Phone: 865-546-0157
  • Fax:
Mailing address:
  • Phone: 865-546-0157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME133194
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number67373
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: