PHILLIP PATRICK RIDEOUT


Address: 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501-3466
Phone: 7702194000

PHILLIP PATRICK RIDEOUT (NPI# 1093153116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093153116
Entity Type Individual
Full Name PHILLIP PATRICK RIDEOUT
Credential MD
Practice Address 200 S Enota Dr Ne Ste 360
Gainesville
GA 30501-3466
Mailing Address Po Box 742616
Atlanta
GA 30374-2616
Practice Telephone 7702194000
Mailing Telephone 7702198420
Enumeration Date 2013-06-11
Last Update Date 2020-07-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208600000X Surgery 6088 GA Allopathic & Osteopathic Physicians
Y 2086S0129X Surgery
Specialization: Vascular Surgery
73048 GA Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
1924 Alcoa Hwy # U-11, Knoxville, TN 37920 8653059006

Office Location

Street Address 200 S ENOTA DR NE STE 360
City GAINESVILLE
State GA
Zip Code 30501-3466

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366417149 James William Becker Physician Assistant 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501-3466 2006-02-23
1366094724 Morgan Dollar Physician Assistant 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501-3466 2019-07-15
1518426774 Chelsea Howell Physician Assistant 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501-3466 2019-03-18
1265852651 Michelle M Davis Nurse Practitioner 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501 2014-04-24
1801109368 Niraj Parikh Surgery 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501-3466 2010-07-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437782851 Madison Raye Huth Physician Assistant 743 Spring Street Se, Gainesville, GA 30501 2020-02-13
1205487659 Grace M Walker Brown Nurse Practitioner 592 Medical Park Dr., Suite A, Gainesville, GA 30501 2019-09-26
1174086987 Nayab Ahmed Student in an Organized Health Care Education/Training Program 743 Spring Street, Suite 710, Gainesville, GA 30501 2019-04-09
1154881118 Ryan D Berry Student in an Organized Health Care Education/Training Program 734 Spring St Se Ste 710, Gainesville, GA 30501 2019-03-24
1609336304 Harper E Niver Student in an Organized Health Care Education/Training Program 743 Spring St., Suite 710, Gainesville, GA 30501 2019-03-20
1508336173 Bradee Burrell Aderholt Nurse Practitioner 663 Lanier Park Drive, Gainesville, GA 30501 2018-11-27
1578068359 Soammy Liz Matias Chiropractor 961 Green Street, Gainesville, GA 30501 2018-03-26
1811496896 Matthew Brown Speech-Language Pathologist 500 Spring St. Se Suite 101, Gainesville, GA 30501 2018-02-06
1346769825 Dr. Skeete & Associates of North Georgia, P.C. Optometrist 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 2017-09-15
1932624723 M & B Imaging, PC Radiology 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 2017-08-14
Find all providers in zip 30501

Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740468396 Cardiac & Vascular Surgery Specialist, Pa Surgery 1121 Nw 64th Terr., Ste A, Gainesville, FL 32605 2008-02-06
1790797421 Anthony Vincent Caggiano Sr. Surgery 1100 Nw 8th Ave, Suite B, Gainesville, FL 32601-2916 2006-08-12
1730479247 Raquel Camille Jones Surgery 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 2011-04-18
1801109368 Niraj Parikh Surgery 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501-3466 2010-07-26
1609040401 Dev Mangalat Surgery 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 2008-04-14
1043407851 Robert L R Wesly M D Ph D P A Surgery 2251 Nw 41st St, Suite E, Gainesville, FL 32606-7498 2007-09-26
1548394455 Robert L R Wesly Surgery 1143 Nw 64th Ter, Gainesville, FL 32605-4218 2007-03-15
1457369258 Charles Daniel Procter Sr. Surgery 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 2006-08-04
1972530822 Timothy C Flynn Surgery 1600 Sw Archer Rd, Gainesville, FL 32610-3003 2006-06-27
1639118532 Scott A Berceli Surgery 1600 Sw Archer Rd, Gainesville, FL 32610-3003 2006-06-06
Find all providers in GAINESVILLE

Competitor

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City GAINESVILLE
Zip Code 30501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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