Provider Demographics
NPI:1922296664
Name:FILIATREAU, RYAN PAUL (PA-C)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:PAUL
Last Name:FILIATREAU
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 HARRODSBURG RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2106
Mailing Address - Country:US
Mailing Address - Phone:859-278-9492
Mailing Address - Fax:
Practice Address - Street 1:2424 HARRODSBURG RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2106
Practice Address - Country:US
Practice Address - Phone:859-278-9492
Practice Address - Fax:859-277-3027
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000541266OtherANTHEM
610957525OtherCOMMERCIAL
KY1047618Medicare PIN