Healthcare Provider Details

I. General information

NPI: 1417337320
Provider Name (Legal Business Name): MARGARET ANN RISO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BROAD ST SE STE B
GAINESVILLE GA
30501-3718
US

IV. Provider business mailing address

601 BROAD ST SE STE B
GAINESVILLE GA
30501-3718
US

V. Phone/Fax

Practice location:
  • Phone: 678-971-4167
  • Fax:
Mailing address:
  • Phone: 678-971-4167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number86165
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number86165
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: