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General NPI Number Information
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NPI Number | 1437496197
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Entity Type | Individual
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Provider Name | RYAN EUGENE DENNEY D.O
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Gender | Male
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 1155 W PARKVIEW ST STE 1F
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City | BOLIVAR
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State | MO
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Zip | 65613
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Country | US
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Telephone | 417-693-0278
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 W PARKVIEW ST STE 1F
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City | BOLIVAR
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State | MO
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Zip | 65613-8597
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2018011480
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | UO3217
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License Number State | FL
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