Individual
MR. DEAN RYAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
241 W WEAVER RD STE 145A, FORSYTH, IL 62535-9765
(217) 876-5270
(217) 875-4001
Mailing address
4155 MCCLAIN DR, DECATUR, IL 62526-1238
(217) 875-0227
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036150782
IL
207Q00000X
Family Medicine Physician
125071567
IL
Other
Enumeration date
03/28/2006
Last updated
12/03/2020
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