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General NPI Number Information
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NPI Number | 1720571490
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Entity Type | Individual
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Provider Name | RYAN LANCE DENSMORE
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Gender | Male
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR DEPT OF
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-2210
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HAWKINS DR DEPT OF
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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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 | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | R-11305
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | R-11305
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207LH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
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License Number | R-11305
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | R-11305
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | R-11305
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License Number State | IA
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Taxonomy #6
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | R-11305
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License Number State | IA
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