Individual
RYAN MICHAEL HEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-9216
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-9216
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2015036773
MO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2015036773
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
04/21/2010
Last updated
11/21/2023
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