Individual
TIMOTHY PETER RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF MEDICINE, JACKSON, MS 39216
(601) 984-5601
(601) 984-6601
Mailing address
2500 N STATE ST, DEPARTMENT OF MEDICINE, JACKSON, MS 39216
(160) 166-7699
(601) 984-6601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
949-L
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/13/2015
Last updated
07/20/2015
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