Individual
RYAN M GOENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3545 W 86TH ST, INDIANAPOLIS, IN 46268-1930
(317) 228-0419
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001363A
IN
363AS0400X
Surgical Physician Assistant
10001363A
IN
363AS0400X
Surgical Physician Assistant
99049555A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430008
MEDICARE PTAN
IN
Enumeration date
11/28/2011
Last updated
01/17/2025
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