Provider Demographics
NPI:1144727637
Name:HLADKY, RYAN (AA)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:HLADKY
Suffix:
Gender:M
Credentials:AA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 413739
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-3739
Mailing Address - Country:US
Mailing Address - Phone:717-263-5562
Mailing Address - Fax:717-263-1566
Practice Address - Street 1:4510 FREDERICK BLVD
Practice Address - Street 2:
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3238
Practice Address - Country:US
Practice Address - Phone:816-364-9992
Practice Address - Fax:816-364-9996
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2020009586367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant