Provider Demographics
NPI:1770721029
Name:GOLDMAN, RYAN MITCHELL (RPA)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:MITCHELL
Last Name:GOLDMAN
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Gender:M
Credentials:RPA
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Mailing Address - Street 1:4500 S GARNETT RD
Mailing Address - Street 2:SUITE919
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5229
Mailing Address - Country:US
Mailing Address - Phone:918-728-6145
Mailing Address - Fax:918-728-6146
Practice Address - Street 1:1500 E DOWNING ST
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3234
Practice Address - Country:US
Practice Address - Phone:918-453-2146
Practice Address - Fax:918-453-2141
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-24
Last Update Date:2009-01-24
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant