Individual
MR. KEITH S RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
1968 PEACHTREE ROAD NW, ATLANTA, GA 30309-1281
(404) 351-1745
(404) 351-7121
Mailing address
1301 CONCORD TERRACE, SUNRISE, FL 33323-2843
(800) 243-3839
(954) 839-2569
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
000866
GA
363A00000X
Physician Assistant
000866
GA
367H00000X
Anesthesiologist Assistant
Primary
000866
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199990101B
—
GA
Enumeration date
03/05/2007
Last updated
10/05/2010
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