Basic Information
Provider Information
NPI: 1851508246
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOOR
FirstName: RYAN
MiddleName: GREGORY
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2800 MAPLE AVE
Address2:  
City: ZANESVILLE
State: OH
PostalCode: 437011716
CountryCode: US
TelephoneNumber: 7404544585
FaxNumber: 7404544008
Practice Location
Address1: 2800 MAPLE AVE
Address2:  
City: ZANESVILLE
State: OH
PostalCode: 437011716
CountryCode: US
TelephoneNumber: 7404544585
FaxNumber: 6145440102
Other Information
ProviderEnumerationDate: 05/17/2007
LastUpdateDate: 06/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X34.009151OHN Allopathic & Osteopathic PhysiciansEmergency Medicine 
261QP2300X OHN Ambulatory Health Care FacilitiesClinic/CenterPrimary Care
207Q00000X34.009151OHY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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