Individual
DR. KELLY W RYDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22127
MS
208M00000X
Hospitalist Physician
2030
TN
208M00000X
Hospitalist Physician
22127
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302I116827
MEDICARE PTAN
MS
01
—
3226035
UNITED HEALTHCARE
MS
01
—
6576308
CIGNA
MS
01
—
9826619
AETNA
MS
01
—
P01109812
RAILROAD MEDICARE
MS
Enumeration date
10/15/2008
Last updated
07/11/2019
Update your record
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