| Gary C Ridenour Md A Prof Corp | |
|
625 W Williams Ave Ste B Fallon NV 89406 | |
| (775) 423-6400 | |
| (775) 423-9411 |
| Full Name | Gary C Ridenour Md A Prof Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 625 W Williams Ave, Fallon, Nevada |
| Authorized Official Name and Position | Gary Charles Ridenour (MD) |
| Authorized Official Contact | 7754236400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary C Ridenour Md A Prof Corp Po Box 1912 Fallon NV 89407 Ph: (775) 423-6400 | Gary C Ridenour Md A Prof Corp 625 W Williams Ave Ste B Fallon NV 89406 Ph: (775) 423-6400 |
| NPI Number | 1043253727 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 05/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043253727 | NPI | - | NPPES |
| 002001209 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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