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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RYAN MARK PROCTOR, D.O.

Active

Procedural Dermatology · BULLHEAD CITY, AZ

Registration Details

NPI Number
1972861326
Provider Type
Individual
Gender
Male
NPI Issued
Apr 23, 2012 (13.996855143766 yrs)
Last Updated
Mar 12, 2014
License
006043 (AZ)

Practice Information

Address
3015 HWAY 95
SUITE 110
BULLHEAD CITY, AZ, 864424334
Browse AZ providers · Browse ZIP 86442
Phone
9287588885
Fax
9287582424
Primary Specialty
Procedural Dermatology
207NS0135X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.