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Individual
HENRY ALBERT PRIDGEN III
Active
Individual
HENRY ALBERT PRIDGEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
64974
TN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
048294
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000866126A
—
GA
01
—
050074558
MEDICARE RAILROAD
GA
01
—
728846
BLUE CROSS BLUE SHIELD
GA
Enumeration date
08/25/2006
Last updated
02/21/2023
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