Provider Demographics
NPI:1306242722
Name:RYAN SANDLIN LLC
Entity type:Organization
Organization Name:RYAN SANDLIN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:D.O. / CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SANDLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:740-354-1434
Mailing Address - Street 1:1729 27TH ST BLDG G
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2638
Mailing Address - Country:US
Mailing Address - Phone:740-354-1434
Mailing Address - Fax:740-354-9427
Practice Address - Street 1:1729 27TH ST BLDG G
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2638
Practice Address - Country:US
Practice Address - Phone:740-354-1434
Practice Address - Fax:740-354-9427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty