Provider Demographics
NPI:1649538471
Name:RICHARD, RYAN PATRICK (MD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:RICHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5246 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4782
Mailing Address - Country:US
Mailing Address - Phone:225-757-4091
Mailing Address - Fax:225-757-4093
Practice Address - Street 1:5246 BRITTANY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4782
Practice Address - Country:US
Practice Address - Phone:225-757-4091
Practice Address - Fax:225-757-4093
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206902207RP1001X, 207R00000X
LA206902207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2199447Medicaid
LA48625YJLCMedicare PIN