Provider Demographics
NPI:1205264405
Name:PRICE, RYAN C (OD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:PRICE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:801 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:AL
Mailing Address - Zip Code:36272-6632
Mailing Address - Country:US
Mailing Address - Phone:256-477-6413
Mailing Address - Fax:256-477-6443
Practice Address - Street 1:801 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:AL
Practice Address - Zip Code:36272-6632
Practice Address - Country:US
Practice Address - Phone:256-477-6413
Practice Address - Fax:256-477-6443
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-B72-TA-762152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist