Individual
DR. S DIANE RICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
117 KITE RD, SWAINSBORO, GA 30401-3231
(478) 289-1100
Mailing address
8569 BRADLEYS LANDING ST, ORLANDO, FL 32827-6909
(315) 480-4241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
259148
NY
207P00000X
Emergency Medicine Physician
Primary
80174
GA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
MD447350
PA
Other
Enumeration date
09/17/2010
Last updated
06/08/2022
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