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Organization
GARY C RIDENOUR MD A PROF CORP
Active
Organization
GARY C RIDENOUR MD A PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY CHARLES RIDENOUR MD (MD)
(775) 423-6400
Entity
Organization
Contact information
Practice address
625 W WILLIAMS AVE, STE B, FALLON, NV 89406
(775) 423-6400
(775) 423-9411
Mailing address
PO BOX 1912, FALLON, NV 89407
(775) 423-6400
(775) 423-9411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002001209
—
NV
Enumeration date
06/13/2006
Last updated
05/31/2011
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