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Individual

CORY M RYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
166 HOSPITAL ST, MONTICELLO, KY 42633-2416
(606) 348-9343
(606) 340-3258
Mailing address
166 HOSPITAL ST, MONTICELLO, KY 42633-2416
(606) 348-9343
(606) 340-3258

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
38039
KY
207Q00000X
Family Medicine Physician
Primary
38039
KY
207R00000X
Internal Medicine Physician
38039
KY
208M00000X
Hospitalist Physician
38039
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000545017
ANTHEM BC & BS
KY
01
0340
MEDICARE GROUP
KY
01
1467443879
NPI
KY
05
64059199
KY
Enumeration date
11/03/2005
Last updated
11/22/2021
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