Individual
JIMMY LYNN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1288 W 12700 S, RIVERTON, UT 84065-6794
(801) 253-3500
(801) 253-5859
Mailing address
PO BOX 1010, RIVERTON, UT 84065-1010
(801) 253-3500
(801) 253-5859
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
172229-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071262
SELECT HEALTH
UT
01
—
870641072RY1
EDUCATORS MUTUAL
UT
01
—
PR00710
MOLINA HEALTHCARE
UT
01
—
QM0000032877
ALTIUS HEALTH PLANS
UT
Enumeration date
06/15/2006
Last updated
02/25/2015
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