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NPI Code Detail

MEDICARE: RYAN LOUIS POHLKAMP

MEDICARE: RYAN LOUIS POHLKAMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1134974108
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN LOUIS POHLKAMP
Provider Business Mailing Address
First Line : 22 ORLE CIR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72223-8928
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 21ST AVE S STE 3000
Second Line :
City : NASHVILLE
State : TN
Zip : 37212-3139
Country : US
Telephone Number : 615-936-3635
Fax Number : 615-936-3156
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2024
Last Update Date : 06/27/2024

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Directions to “ RYAN LOUIS POHLKAMP ” Practice Location

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