Robert S Riddick Mdpc

NPI #1760692388 in Vidalia, Georgia

Provider Information

NPI Number: 1760692388
Entity Type: Organization
Organization Name: Robert S Riddick Mdpc
Primary Specialty: Surgery
Enumeration Date: May 23, 2007
Last Updated: Dec 28, 2007

Practice Location

Address: 106 QUEEN STREET
Address 2: SUITE 4
City: Vidalia
State: Georgia
ZIP Code: 30474
Phone: (912) 538-8545

Authorized Official

Name: DR. ROBERT STEVEN RIDDICK, MD
Title: PHYSICIAN OWNER
Phone: (912) 538-8545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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