Provider Demographics
NPI:1073738167
Name:SENN, ERIC RYAN (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:RYAN
Last Name:SENN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1513
Mailing Address - Country:US
Mailing Address - Phone:706-571-1823
Mailing Address - Fax:706-660-2685
Practice Address - Street 1:1800 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1513
Practice Address - Country:US
Practice Address - Phone:706-571-1823
Practice Address - Fax:706-660-2685
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001954207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine