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1144340498

NPI Code Detail

MEDICARE: RYAN K STALLINGS MD

MEDICARE: RYAN K STALLINGS MD

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
1	2083X0100X	Occupational Medicine Physician	K3941	TX
2	207Q00000X	Family Medicine Physician	K3941	TX
3	207Q00000X	Family Medicine Physician	46066	CO
4	207Q00000X	Family Medicine Physician	46066	OR
5	2083X0100X	Occupational Medicine Physician	46066	CO

General Provider Information

NPI Number	:	1144340498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN K STALLINGS MD

Provider Business Mailing Address
First Line	:	2322 S ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80916-2406
Country	:	US
Telephone Number	:	719-390-1727
Fax Number	:	719-390-9690

Provider Business Practice Location Address
First Line	:	2322 S ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80916-2406
Country	:	US
Telephone Number	:	719-390-1727
Fax Number	:	719-390-9690

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	11/22/2011

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Directions to “ RYAN K STALLINGS MD” Practice Location

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