RYAN MARK PROCTOR (NPI# 1972861326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972861326 |
| Entity Type | Individual |
| Full Name | RYAN MARK PROCTOR |
| Credential | D.O. |
| Practice Address |
3015 Hway 95 Suite 110 Bullhead City AZ 86442-4334 |
| Practice Telephone | 9287588885 |
| Practice Fax Number | 9287582424 |
| Mailing Telephone | 9287588885 |
| Mailing Fax Number | 9287582424 |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2014-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
006043 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
3015 HWAY 95 SUITE 110 |
| City | BULLHEAD CITY |
| State | AZ |
| Zip Code | 86442-4334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063403269 | Heather A Shelton | Psychiatry & Neurology | 3015 Hway 95, # 109, Bullhead City, AZ 86442-4334 | 2005-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346869039 | Westcare Arizona I, Inc. | Substance Abuse Rehabilitation Facility | 1160 Agate Rd, Bullhead City, AZ 86442 | 2020-04-13 |
| 1710544895 | Assured Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 1665 Rainbow Dr Ste 7, Bullhead City, AZ 86442 | 2019-05-23 |
| 1306304845 | Muna Basnet Bhattarai | Nurse Practitioner | 3015 Hway 95 Ste 109, Bullhead City, AZ 86442 | 2019-03-04 |
| 1225508757 | Desert Springs Urgent Care, PC | Clinic/Center | 3706 Highway 95 Ste 1, Bullhead City, AZ 86442 | 2018-11-27 |
| 1750863114 | Susenie Delva Pierre | Nurse Practitioner | 3003 Hwy. 95, Suite 101, Bullhead City, AZ 86442 | 2018-09-02 |
| 1255819736 | Phoenix Cancer and Blodd Disorder Treatment Institute | Internal Medicine | 967 Hancock Rd 133, Bullhead City, AZ 86442 | 2018-08-06 |
| 1487140539 | Akdhc, LLC | Internal Medicine | 2771 Silver Creek Rd Ste 120, Bullhead City, AZ 86442 | 2018-07-02 |
| 1225543036 | Tri-state Sinus Center | Otolaryngology | 2020 Silver Creek, B101, Bullhead City, AZ 86442 | 2017-12-04 |
| 1396297123 | Henry Sy | Pharmacist | 2360 Az-95, Bullhead, AZ 86442 | 2016-10-27 |
| 1861854267 | Joshua Springs Operations LLC | Health Maintenance Organization | 2995 Desert Sky Blvd, Bullhead City, AZ 86442 | 2016-03-24 |
| Find all providers in zip 86442 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871051383 | Skin Deep Aesthetics, LLC | Dermatology | 1714 W Guadalupe Rd Ste 201, Gilbert, AZ 85233-2943 | 2019-03-05 |
| 1982819397 | Tamra Whiteley-myers Md PC | Dermatology | 5190 E Farness Dr Ste 110, Tucson, AZ 85712-2142 | 2007-05-11 |
| 1871653840 | Cynthia Jean Modny | Dermatology | 2402 E San Miguel Ave, Phoenix, AZ 85016-2815 | 2006-12-11 |
| 1518928878 | Mark A Meyers | Dermatology | 715 S Beeline Hwy, Ste A, Payson, AZ 85541-5344 | 2006-03-28 |
| 1235128851 | Andrew S. Tedesco | Dermatology | 6648 E Carondelet Dr, Tucson, AZ 85710-2119 | 2005-10-17 |
| 1861498297 | Keith Andrew Mackenzie | Dermatology | 3190 Clearwater Dr, Prescott, AZ 86305-7131 | 2005-06-21 |
| 1083066450 | Arizona Skin and Laser Therapy Institue, Ltd | Dermatology | 16620 N 40th St, Suite C-3, Phoenix, AZ 85032-3348 | 2016-07-08 |
| 1548634348 | La Peau Dermatology LLC | Dermatology | 5424 E Southern Ave, Suite 103, Mesa, AZ 85206-3621 | 2015-11-17 |
| 1427340389 | Brenda Latowsky M.d. P.l.c. | Dermatology | 12251 N 32nd St, Phoenix, AZ 85032-7189 | 2011-05-11 |
| 1003112327 | Northern Arizona Dermatology Center, PC | Dermatology | 501 N Navajo, Page, AZ 86040 | 2011-02-03 |
| Find all providers with the same taxonomy | ||||
| City | BULLHEAD CITY |
| Zip Code | 86442 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.