Provider Demographics
NPI:1003148198
Name:MATIKA, RYAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:WILLIAM
Last Name:MATIKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 W KIWI LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-8937
Mailing Address - Country:US
Mailing Address - Phone:520-572-1773
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - Street 2:1501 N. CAMPBELL AVENUE
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41305207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology