Healthcare Provider Details

I. General information

NPI: 1942279385
Provider Name (Legal Business Name): RINGGOLD MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

886 LAFAYETTE ST
RINGGOLD GA
30736
US

IV. Provider business mailing address

886 LAFAYETTE ST
RINGGOLD GA
30736
US

V. Phone/Fax

Practice location:
  • Phone: 706-935-4020
  • Fax: 706-965-8228
Mailing address:
  • Phone: 706-935-4020
  • Fax: 706-965-8228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number761
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number030915
License Number StateGA

VIII. Authorized Official

Name: MRS. ROSEANNE TSUI
Title or Position: PART OWNER VICE PRESIDENT
Credential:
Phone: 706-935-4020