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General NPI Number Information
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NPI Number | 1265781884
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Entity Type | Organization
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Legal Business Name | RYAN P CONLEY PLLC
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 9343 S MINGO RD
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City | TULSA
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State | OK
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Zip | 74133-5702
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Country | US
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Telephone | 918-994-4104
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Fax |
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Provider Business Mailing Address
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Address Line | 1942 S EVANSTON AVE
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City | TULSA
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State | OK
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Zip | 74104-6128
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Country | US
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Telephone | 918-231-1466
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN P CONLEY
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Credential | DO
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Telephone | 918-231-1466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4394
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License Number State | OK
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