Provider Demographics
NPI:1316010788
Name:RYAN, WILLIAM JR (MSO/NAVY IDC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:RYAN
Suffix:JR
Gender:M
Credentials:MSO/NAVY IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 473 BOX 1710
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96349
Mailing Address - Country:US
Mailing Address - Phone:8146-816-2457
Mailing Address - Fax:
Practice Address - Street 1:USS EMORY S LAND (AS 39)
Practice Address - Street 2:UNIT 100104 - MSC MEDICAL
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96667
Practice Address - Country:US
Practice Address - Phone:757-687-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman