Individual
RYAN DAVID MAHELONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
230 W CENTER ST, FAYETTEVILLE, AR 72701-5934
(623) 217-1716
Mailing address
316 S GREGG AVE, FAYETTEVILLE, AR 72701-5860
(623) 217-1716
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
60084
AZ
2084P0800X
Psychiatry Physician
Primary
E-16683
AR
Other
Enumeration date
04/20/2018
Last updated
10/03/2024
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