Provider Demographics
NPI:1124214945
Name:SKINNER, RYAN TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:TODD
Last Name:SKINNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2224 NW 50TH ST
Mailing Address - Street 2:STE 276W
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8088
Mailing Address - Country:US
Mailing Address - Phone:405-486-7255
Mailing Address - Fax:706-653-8732
Practice Address - Street 1:2224 NW 50TH ST
Practice Address - Street 2:SUITE 276W
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8046
Practice Address - Country:US
Practice Address - Phone:405-858-2350
Practice Address - Fax:405-858-2365
Is Sole Proprietor?:No
Enumeration Date:2007-09-16
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK260932085R0202X
TXM76392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology