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General NPI Number Information
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NPI Number | 1821442591
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Entity Type | Individual
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Provider Name | RYAN HAYDEN MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 01/15/2019
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Provider Practice Location Address
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Address Line | 3500 GASTON AVE
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City | DALLAS
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State | TX
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Zip | 75246
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Country | US
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Telephone | 214-820-2361
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Fax |
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Provider Business Mailing Address
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Address Line | 2125 S GOLDEN HILLS ST
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City | WICHITA
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State | KS
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Zip | 67209-4284
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Country | US
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Telephone | 316-250-0220
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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 | 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 #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R4235
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License Number State | TX
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