Individual
DR. KELLY RYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
(318) 320-4422
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-0996
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.202250
LA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD.202250
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1343412
—
LA
01
—
1K0937
MEDICARE
LA
Enumeration date
02/13/2007
Last updated
02/07/2025
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