Provider Demographics
NPI:1013429000
Name:PRICE, RYAN H (PA-C)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:H
Last Name:PRICE
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 1:1645 W ARCADIA LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-5063
Mailing Address - Country:US
Mailing Address - Phone:928-920-4627
Mailing Address - Fax:
Practice Address - Street 1:1230 W 24TH ST STE 1
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6232
Practice Address - Country:US
Practice Address - Phone:928-314-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant