Provider Demographics
NPI:1255566345
Name:DOGGETT, RYAN PATRICK (PA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:DOGGETT
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:888-339-6065
Mailing Address - Fax:855-308-2340
Practice Address - Street 1:1983 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2122
Practice Address - Country:US
Practice Address - Phone:828-651-0450
Practice Address - Fax:855-308-2340
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06252363A00000X
FL9104575363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC125566345OtherMEDICAID
NCCS2503400868OtherCARESOURCE
NCNN5544AOtherMEDICARE
NC200XWOtherBCSB NC
NC4129896OtherCIGNA