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General NPI Number Information
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NPI Number | 1265449060
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Entity Type | Individual
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Provider Name | LUCY HABERTHIER-RYAN MD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 01/03/2026
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Provider Practice Location Address
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Address Line | 1180 COLLEGE DR
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5863
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Country | US
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Telephone | 307-212-7717
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Fax | 307-212-7513
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Provider Business Mailing Address
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Address Line | 501 S RAGSDALE ST
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City | JACKSONVILLE
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State | TX
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Zip | 75766-2434
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Country | US
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Telephone | 903-541-5460
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Fax | 903-541-5470
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J5094
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 12406A
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License Number State | WY
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