Phillip Patrick Rideout
Surgeon Vascular Surgeon
200 S Enota Dr Ne Ste 360
Gainesville
, Georgia 30501-3466
Phillip Patrick Rideout
Surgeon Vascular Surgeon
200 S Enota Dr Ne Ste 360
Gainesville
, Georgia 30501-3466
(770) 219-8420
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About
Features
Specialties
- Surgeon
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Phillip Patrick Rideout
- Po Box 742616
- Atlanta, GA
- Zip : 30374-2616
- Phone : (770) 219-8420
Second Address
- Phillip Patrick Rideout
- 200 S Enota Dr Ne Ste 360
- Gainesville, GA
- Zip : 30501-3466
- Phone : (770) 219-4000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 6088 | GA |
| N | 208600000X | Surgeon | 6088 | GA |
| Y | 2086S0129X | Vascular Surgeon | 73048 | GA |
National Provider Identifier
| NPI | 1093153116 |
|---|---|
| Provider Name | Phillip Patrick Rideout |
| First Address | Atlanta, GA 30374-2616 |
| Second Address | Gainesville, GA 30501-3466 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2013 |
| Last Update Date | 22/01/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.