Individual
DR. TIMOTHY JOHN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 249-0212
Mailing address
402 W NORTHVIEW AVE, PHOENIX, AZ 85021-8740
(602) 678-4241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3138
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39 81220
EVERCARE GRP
AZ
05
—
436742
—
AZ
01
—
453051001
GROUP HEALTH GRP
AZ
01
—
86 0373636
HUMANA GROUP
AZ
01
—
AW1436
HEALTHNET GRP
AZ
01
—
AZ0728670
BLUE CROSS BLUE SHIELD GR
AZ
Enumeration date
11/07/2005
Last updated
08/08/2014
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