Individual
RYAN KIRK BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2855 E BROWN RD STE 28, MESA, AZ 85213-4217
(480) 625-4538
(480) 625-4561
Mailing address
2855 E BROWN RD STE 28, MESA, AZ 85213-4217
(480) 625-4538
(480) 625-4561
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6905
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14099384
CAQH
AZ
01
—
6905
PHYSICIAN ASSISTANT AZ STATE LICENSE
AZ
Enumeration date
09/20/2017
Last updated
09/08/2025
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