Individual
JEFFREY ALLAN RYSDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
823 SW MULVANE ST, SUITE 275, TOPEKA, KS 66606-1764
(785) 270-4355
(785) 270-4356
Mailing address
823 SW MULVANE ST, SUITE 275, TOPEKA, KS 66606-1764
(785) 270-4355
(785) 270-4356
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01524
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002161
MEDICARE PTAN
KS
Enumeration date
01/18/2012
Last updated
05/18/2012
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