Moon, Martin Ryan

Moon, Martin Ryan is an individual health care provider with primary practice located at 4900 Houston Rd , Florence KY 41042-4824. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Moon, Martin Ryan can be contacted via phone (859) 578-5880.

Contact Information

Primary practice address
4900 Houston Rd Florence KY 41042-4824
Phone: (859) 578-5880
Fax: (859) 578-5881
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 35-070819 Ohio
Allopathic & Osteopathic Physicians / Surgery 208600000X 39444 Kentucky

Profile Details

NPI number 1174516934
LBN Legal business name Moon, Martin Ryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Nov 18th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174516934 NPPES
Kentucky MEDICAID 64108491

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