Healthcare Provider Details

I. General information

NPI: 1174595904
Provider Name (Legal Business Name): GUIDO H RING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 01/26/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N 7TH ST
CORDELE GA
31015-3234
US

IV. Provider business mailing address

307 E 3RD AVE
CORDELE GA
31015-3208
US

V. Phone/Fax

Practice location:
  • Phone: 229-276-3100
  • Fax:
Mailing address:
  • Phone: 229-271-4656
  • Fax: 229-271-4654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number045325
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number045325
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00848504B
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerDIALYSIS
# 2
Identifier000848504B
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer
# 3
Identifier00848504A
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: