Provider Demographics
NPI:1356845051
Name:BANNING, RYAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:CHRISTOPHER
Last Name:BANNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1500 DODSON AVE STE 175
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-5180
Mailing Address - Country:US
Mailing Address - Phone:479-573-7940
Mailing Address - Fax:479-573-7941
Practice Address - Street 1:1500 DODSON AVE STE 175
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-5180
Practice Address - Country:US
Practice Address - Phone:479-573-7940
Practice Address - Fax:479-573-7941
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-16592208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery