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NPI 1073018958

NPI 1073018958 : RYAN J KASKY DO : FALLON, NV

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General NPI Number Information
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    NPI Number           |    1073018958
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    Entity Type          |    Individual 
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    Provider Name        |    RYAN J KASKY DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2018
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    Last Update Date     |    06/11/2024
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Provider Practice Location Address
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    Address Line         |    801 E WILLIAMS AVE 
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    City                 |    FALLON
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    State                |    NV
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    Zip                  |    89406-3052
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    Country              |    US
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    Telephone            |    775-867-7740
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    Fax                  |    775-867-7741
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Provider Business Mailing Address
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    Address Line         |    10510 JEFFERSON AVE STE A 
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    City                 |    NEWPORT NEWS
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    State                |    VA
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    Zip                  |    23601-3102
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    Country              |    US
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    Telephone            |    757-594-3800
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    Fax                  |    757-594-3818
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    DO2996
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    License Number State |    NV
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