Individual
RYAN GLENN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3413
(405) 928-2530
Mailing address
PO BOX 269065, OKLAHOMA CITY, OK 73126-9065
(405) 486-7250
(706) 653-1567
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
23595
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200252290A
—
OK
Enumeration date
04/17/2007
Last updated
03/16/2017
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