Ellsworth, Ryan Scott

Ellsworth, Ryan Scott is an sole proprietor health care provider with primary practice located at 505 Fairburn Rd Sw Ste 100 , Atlanta GA 30331-2012. He recently has 6 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot Surgery is his primary health care specialty. Ellsworth, Ryan Scott can be contacted via phone (404) 618-6077.

Contact Information

Primary practice address
505 Fairburn Rd Sw Ste 100 Atlanta GA 30331-2012
Phone: (404) 618-6077
Fax: (801) 253-6888
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 2109 Nevada
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E5797 California
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO4406 Florida
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD001473 Georgia
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 8400193-0501 Utah
Podiatric Medicine & Surgery Service Providers / Radiology 213ER0200X 8400193-0501 Utah
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X 8400193-0501 Utah
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 8400193-0501 Utah
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 8400193-0501 Utah

Profile Details

NPI number 1104130574
LBN Legal business name Ellsworth, Ryan Scott
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2010
Last updated Jun 17th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104130574 NPPES
Utah MEDICAID 1003111
Utah Other 8400193-0501
Utah Other 7672880001
Utah Other E5797
Utah Other POD001473
Utah Other PO4406
Utah Other 2109

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