Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS13011 | FL |
NPI | 1003825423 |
---|---|
Provider Name | Ryan P Pharr |
First Address | Pensacola, FL 32513-2699 |
Second Address | Apalachicola, FL 32320-1763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 13/09/2017 |