Individual
DR. RYAN HODNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
80 B VETERANS BLVD, PUEBLO OF ACOMA, NM 87034
(505) 552-5300
(505) 552-5490
Mailing address
P.O. BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5300
(505) 552-5490
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A-1756-13
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
03/24/2010
Last updated
12/28/2020
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