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General NPI Number Information
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NPI Number | 1346735685
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Entity Type | Individual
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Provider Name | JAMES JOSEPH RYAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 2714 UNION AVENUE EXT STE 150
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City | MEMPHIS
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State | TN
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Zip | 38112-4431
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Country | US
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Telephone | 901-725-0872
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Fax | 901-278-6934
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Provider Business Mailing Address
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Address Line | PO BOX 746725
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City | ATLANTA
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State | GA
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Zip | 30374-6725
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Country | US
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Telephone | 469-727-6675
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 66301
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 66301
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License Number State | TN
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