# RYAN AVERETT DPM PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679514186
- **Authorized official:** DR. RYAN KENNETH AVERETT D.P.M. (PRESIDENT)
- **Authorized official phone:** (208) 661-0295

## Contact information

- **Practice address:** 2221 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2697
- **Practice address phone:** (208) 667-3585
- **Practice address fax:** (855) 864-8364
- **Mailing address:** 1118 N 4TH ST, COEUR D ALENE, ID 83814-3217
- **Mailing address phone:** (208) 667-3585
- **Mailing address fax:** (208) 666-9214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | P177 | ID | Yes |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 07/21/2022