Provider Demographics
NPI:1174987655
Name:BEAUMONT, RYANN (DO)
Entity type:Individual
Prefix:MS
First Name:RYANN
Middle Name:
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:RYANN
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:5001 WATTSBURG RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-2747
Mailing Address - Country:US
Mailing Address - Phone:814-440-7360
Mailing Address - Fax:
Practice Address - Street 1:311 W 24TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2665
Practice Address - Country:US
Practice Address - Phone:814-452-5109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT016946207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine