Provider Demographics
NPI:1427348796
Name:RYAN, EMILY MILLS (DO)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MILLS
Last Name:RYAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20805 W 151ST ST # 224
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7249
Mailing Address - Country:US
Mailing Address - Phone:913-782-8300
Mailing Address - Fax:913-782-1574
Practice Address - Street 1:20805 W 151ST ST # 224
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7249
Practice Address - Country:US
Practice Address - Phone:913-782-8300
Practice Address - Fax:913-782-1574
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-39738207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS033D00160OtherMEDICARE
KS201155980AMedicaid