Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 33881 | AZ |
N | 207VG0400X | Gynecologist | 33881 | AZ |
NPI | 1689668493 |
---|---|
Provider Name | Dr. Ryan R Stratford |
First Address | Belfast, ME 04915-4012 |
Second Address | Mesa, AZ 85215-1134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 04/08/2015 |