Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 00012527 | AL |
NPI | 1255460135 |
---|---|
Provider Name | Dr. Thomas Richard Ryder |
First Address | Birmingham, AL 35213-1972 |
Second Address | Birmingham, AL 35213-1972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R35846 | (02) | AL |