Provider Demographics
NPI:1407084627
Name:RYMAN, DAVIS CLANCY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVIS
Middle Name:CLANCY
Last Name:RYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8111
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-286-1967
Mailing Address - Fax:314-286-1985
Practice Address - Street 1:4488 FOREST PARK AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2215
Practice Address - Country:US
Practice Address - Phone:314-286-1967
Practice Address - Fax:314-286-1985
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20130303262084N0400X
MO2009015655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology