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Individual

RICHARD A RYDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
220 J.L. WHITE DRIVE, SUITE 100, JASPER, GA 30143-4894
(706) 636-6500
(706) 636-6502
Mailing address
175 SAMARITAN DR, JASPER, GA 30143-1964
(706) 253-4673
(404) 351-5983

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
068550
GA
207RC0000X
Cardiovascular Disease Physician
119559
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003128026A
GA
05
00586567
NY
Enumeration date
05/17/2006
Last updated
07/30/2020
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