Provider Demographics
NPI:1902424005
Name:DOZAR, RYAN E (NP-C)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:E
Last Name:DOZAR
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 BELANGER ST STE 108
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4401
Mailing Address - Country:US
Mailing Address - Phone:985-868-2302
Mailing Address - Fax:
Practice Address - Street 1:855 BELANGER ST STE 108
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4401
Practice Address - Country:US
Practice Address - Phone:985-868-2302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA213664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily