Thomas P Ryan, DO | |
2622 Lake Ave, Fort Wayne, IN 46805-5410 | |
(260) 425-3100 | |
(260) 425-3604 |
Full Name | Thomas P Ryan |
---|---|
Gender | Male |
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 2622 Lake Ave, Fort Wayne, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275507055 | NPI | - | NPPES |
100330950 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | 02001220A (Indiana) | Primary |
Entity Name | St Joseph Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811952070 PECOS PAC ID: 2264413491 Enrollment ID: O20040525001030 |
Mailing Address | Practice Location Address |
---|---|
Thomas P Ryan, DO 2622 Lake Ave, Fort Wayne, IN 46805-5410 Ph: (260) 425-3100 | Thomas P Ryan, DO 2622 Lake Ave, Fort Wayne, IN 46805-5410 Ph: (260) 425-3100 |
Dr. Dustin M Thomas, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 11108 Parkview Plaza Dr, Fort Wayne, IN 46845 Phone: 260-266-5700 Fax: 260-266-5910 | |
Ahmad Alhariri, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 11109 Parkview Plaza Dr, Fort Wayne, IN 46845 Phone: 260-266-2020 | |
Dr. Anuradha G Bommakanti, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-435-7001 | |
Eileen Jill Ramos Muzzillo, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 4402 E State Blvd, Fort Wayne, IN 46815 Phone: 260-425-5600 Fax: 260-425-5605 | |
John T Ducker, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 7836 W Jefferson Blvd, Suite 101, Fort Wayne, IN 46804 Phone: 260-494-3484 Fax: 260-969-0188 | |
Mr. Kenneth A Smith, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 1234 East Dupont Road, Suite 5, Fort Wayne, IN 46825 Phone: 260-489-1666 Fax: 260-489-3255 | |
Dr. Carl Marc Williams, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 11104 Parkview Circle Dr, Fort Wayne, IN 46845 Phone: 260-373-9700 Fax: 260-373-9740 |