Individual
RYAN N DAVIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-9729
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2013011066
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295927473
—
MO
05
—
198618003
—
AR
01
—
431560263
TRICARE
MO
01
—
P01210611
RR MCR
MO
Enumeration date
08/13/2007
Last updated
10/29/2013
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