Individual
THAD RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 MEDICAL DR NE, CARTERSVILLE, GA 30121-8003
(770) 386-5221
Mailing address
15 MEDICAL DR NE, CARTERSVILLE, GA 30121-8003
(770) 386-5221
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
049842
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00953114A
—
GA
Enumeration date
04/04/2006
Last updated
01/20/2014
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