| James T Ryan D O Pllc | |
|
300 S Rath Ave Suite 202 Ludington MI 49431-3003 | |
| (231) 425-4447 | |
| (231) 425-4401 |
| Full Name | James T Ryan D O Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 S Rath Ave, Ludington, Michigan |
| Authorized Official Name and Position | James T Ryan (PHYSICAN, SOLE MBR) |
| Authorized Official Contact | 2314254447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James T Ryan D O Pllc 300 S Rath Ave Suite 202 Ludington MI 49431-3003 Ph: (231) 425-4447 | James T Ryan D O Pllc 300 S Rath Ave Suite 202 Ludington MI 49431-3003 Ph: (231) 425-4447 |
| NPI Number | 1336557271 |
|---|---|
| Provider Enumeration Date | 07/23/2014 |
| Last Update Date | 07/23/2014 |
| Medicare PECOS PAC ID | 5698993145 |
|---|---|
| Medicare Enrollment ID | O20140826001226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336557271 | NPI | - | NPPES |
| M19520029 | Other | MI | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 510106838 (Michigan) | Primary |
| Provider Name | James T Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437271996 PECOS PAC ID: 0042361404 Enrollment ID: I20090624000438 |
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