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General NPI Number Information
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NPI Number | 1548200504
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Entity Type | Individual
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Provider Name | JEFF L RYAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 7559 N TONGASS HWY
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City | KETCHIKAN
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State | AK
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Zip | 99901-9182
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Country | US
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Telephone | 907-228-0185
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Fax | 907-225-0184
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Provider Business Mailing Address
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Address Line | PO BOX 7132
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City | KETCHIKAN
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State | AK
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Zip | 99901-2132
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Country | US
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Telephone | 907-228-0185
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 116345
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD22074
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License Number State | AL
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