Organization
KEITH A RYAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH A RYAN MD (REGISTERED AGENT)
(307) 235-4020
Entity
Organization
Contact information
Practice address
1233 E 2ND ST, CASPER, WY 82601-2926
(307) 577-7201
Mailing address
2510 E 15TH ST, SUITE 2, CASPER, WY 82609-4111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
7118A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120997300
—
WY
01
—
313512
BLUE CROSS BLUE SHEILD OF WYOMING
WY
Enumeration date
02/24/2009
Last updated
05/09/2012
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