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NPI 1538295845

NPI 1538295845 : LARRY MADISON RYLE M.D. : SHEPHERDSVILLE, KY

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General NPI Number Information
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    NPI Number           |    1538295845
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    Entity Type          |    Individual 
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    Provider Name        |    LARRY MADISON RYLE M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/23/2007
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    Last Update Date     |    08/30/2024
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Provider Practice Location Address
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    Address Line         |    115 HUSTON DR STE 1 
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    City                 |    SHEPHERDSVILLE
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    State                |    KY
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    Zip                  |    40165-7250
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    Country              |    US
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    Telephone            |    502-955-7311
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    Fax                  |    502-955-9694
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Provider Business Mailing Address
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    Address Line         |    PO BOX 766351 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60677-6351
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    Country              |    US
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    Telephone            |    502-588-9490
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    Fax                  |    502-272-5116
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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       |    43434
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    License Number State |    KY
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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        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    43434
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    License Number State |    KY
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