Provider Demographics
NPI:1184374753
Name:FLYNN, RYAN EDWARD (DO)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:EDWARD
Last Name:FLYNN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-4515
Mailing Address - Country:US
Mailing Address - Phone:845-591-4211
Mailing Address - Fax:
Practice Address - Street 1:2145 N FAIRFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2783
Practice Address - Country:US
Practice Address - Phone:937-558-3900
Practice Address - Fax:937-558-3999
Is Sole Proprietor?:No
Enumeration Date:2022-03-26
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program