Provider Demographics
NPI:1780776849
Name:NAFFZIGER, RYAN T (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:T
Last Name:NAFFZIGER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:175 MERCADO ST
Mailing Address - Street 2:STE 111
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7318
Mailing Address - Country:US
Mailing Address - Phone:970-828-1199
Mailing Address - Fax:970-828-1194
Practice Address - Street 1:175 MERCADO ST
Practice Address - Street 2:STE 111
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7318
Practice Address - Country:US
Practice Address - Phone:970-828-1199
Practice Address - Fax:970-828-1194
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-06-10
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Provider Licenses
StateLicense IDTaxonomies
CO47396208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91985579Medicaid
CO91985579Medicaid