Robert S Riddick Mdpc

Surgery · Vidalia, GA

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At a glance

106 Queen Street, Vidalia, GA 30474

NPPES record updated Dec 28, 2007. Public records can lag behind changes at a practice.

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Practice location

106 Queen Street Suite 4
Vidalia, GA 30474

Professional details: NPI, taxonomy & registry record

NPI1760692388

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Registry details

Primary taxonomy: Surgery
Taxonomy code: 208600000X
Enumeration date: May 23, 2007
Record updated: Dec 28, 2007

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Surgery

208600000X · Primary

License reported: 054933 GA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

106 Queen Street
Suite 4
Vidalia, GA 30474

Phone: (912) 538-8545
Fax: (912) 538-8547

Mailing address

PO BOX 1047

VIDALIA, GA 304751047

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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