person
Ryan Scott Ellsworth, DPM
Foot Surgery Podiatrist in Atlanta, Georgia
NPI 1104130574

Ryan Scott Ellsworth is a Foot Surgery Podiatrist based in Sandy, GA and is specialized in Foot Surgery. Ryan Scott Ellsworth practices in Atlanta, GA and has the professional credentials of DPM. The NPI Number for Ryan Scott Ellsworth is 1104130574 and holds a License No. 2109 (Georgia).

The current practice location address for Ryan Scott Ellsworth is 505 Fairburn Rd Sw Ste 100, Atlanta, GA and can be reached out via phone at 404-618-6077 and via fax at 801-253-6888.

Location: 505 Fairburn Rd Sw Ste 100, Atlanta, GA, 84070-3654
person
Provider Profile Details
NPI Number
1104130574
Provider Name
Ryan Scott Ellsworth
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
505 Fairburn Rd Sw Ste 100, Atlanta, GA, 84070-3654
Phone Number
404-618-6077
Fax Number
801-253-6888
Provider Enumeration Date
07/28/2010
Last Update Date
07/20/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1003111 05 UT
8400193-0501 01 UT UT DPM LICENSE
7672880001 01 UT DME
E5797 01 CA CA DPM LICENSE
POD001473 01 GA GA DPM LICENSE
PO4406 01 FL FL DPM LICENSE
2109 01 NV NV DPM LICENSE
institution
Provider Business Practice Location Address Details
Address
505 Fairburn Rd Sw Ste 100
City
State
Zip
30331-2012
Phone Number
404-618-6077
Fax Number
801-253-6888
person
Provider Business Mailing Address Details
Address
505 Fairburn Rd Sw Ste 100
City
State
Zip
30331-2012
Phone Number
404-618-6077
Fax Number
801-253-6888
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
License No.
8400193-0501 (Utah)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
License No.
8400193-0501 (Utah)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Radiology
Taxonomy
License No.
POD001473 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Sports Medicine
Taxonomy
License No.
PO4406 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
E5797 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 6
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
2109 (Nevada)
Definition
Definition to come...
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