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General NPI Number Information
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NPI Number | 1639733470
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Entity Type | Individual
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Provider Name | RYAN DIDDE MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2019
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 330 ARKANSAS ST STE 205
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City | LAWRENCE
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State | KS
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Zip | 66044-1485
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Country | US
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Telephone | 785-505-5045
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Fax | 785-505-5288
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Provider Business Mailing Address
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Address Line | 325 MAINE ST MSO LIBRARY
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City | LAWRENCE
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State | KS
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Zip | 66044-1360
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Country | US
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Telephone | 785-505-2988
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Fax | 785-505-5228
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0451757
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License Number State | KS
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