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General NPI Number Information
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NPI Number | 1487690673
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Entity Type | Individual
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Provider Name | RYAN D. MUCHOW M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 10/10/2017
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Provider Practice Location Address
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Address Line | 110 CONN TER
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City | LEXINGTON
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State | KY
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Zip | 40508-3206
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Country | US
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Telephone | 859-268-5622
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Fax | 859-268-5636
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Provider Business Mailing Address
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Address Line | 740 S LIMESTONE SUITE K401 KENTUCKY CLINIC
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City | LEXINGTON
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State | KY
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Zip | 40536-0284
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Country | US
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Telephone | 859-323-5533
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Fax | 859-323-2412
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 45326
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License Number State | KY
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