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General NPI Number Information
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NPI Number | 1053638981
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Entity Type | Individual
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Provider Name | RYAN CRAIG LEBARON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | MSC10 5530 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-6225
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 37154
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 19035A
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD2013-0574
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DR.0075798
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License Number State | CO
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