Provider Demographics
NPI:1063890630
Name:MCCAFFERTY, RYAN PATRICK (DO)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:MCCAFFERTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 FOREST DR STE C
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-7088
Mailing Address - Country:US
Mailing Address - Phone:614-939-5416
Mailing Address - Fax:
Practice Address - Street 1:5031 FOREST DR STE C
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-7088
Practice Address - Country:US
Practice Address - Phone:614-939-5416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014575207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology