Individual
RYAN DANIEL LURTSEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Mailing address
3601 4TH STREET MAIL STOP 9901, LUBBOCK, TX 79430-0002
(806) 743-2757
(806) 743-1180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD218786
OR
207Q00000X
Family Medicine Physician
R8935
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
R8935
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500837289
—
OR
Enumeration date
05/10/2017
Last updated
08/11/2024
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