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NPI Code Detail

MEDICARE: RYAN DAVID VINCENT M.D.

MEDICARE: RYAN DAVID VINCENT M.D.
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
1207W00000XOphthalmology PhysicianN6755TX
2207W00000XOphthalmology Physician04-35204KS
3207W00000XOphthalmology Physician2011026868MO
4207WX0009XGlaucoma Specialist (Ophthalmology) PhysicianMD-41715IA
5207W00000XOphthalmology PhysicianMD-41715IA

General Provider Information

NPI Number : 1700094109
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN DAVID VINCENT M.D.
Provider Business Mailing Address
First Line : 309 E CHURCH ST
Second Line :
City : MARSHALLTOWN
State : IA
Zip : 50158-2946
Country : US
Telephone Number : 800-542-7956
Fax Number : 641-754-6245
Provider Business Practice Location Address
First Line : 2020 PHILADELPHIA ST
Second Line :
City : AMES
State : IA
Zip : 50010-8772
Country : US
Telephone Number : 515-232-2450
Fax Number : 515-232-3532
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 02/15/2018

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