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Individual

RYAN MARK TRUXILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8050 W JUDGE PEREZ DR, SUITE 3100, CHALMETTE, LA 70043-1734
(504) 304-2800
(504) 826-9650
Mailing address
8050 W JUDGE PEREZ DR, SUITE 3100, CHALMETTE, LA 70043-1734
(504) 304-2800
(504) 826-9650

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
201607
LA
207Q00000X
Family Medicine Physician
Primary
MD201607
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1143570
LA
05
2319680
LA
01
255644YJ78
PTAN
Enumeration date
06/06/2006
Last updated
06/18/2014
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