NPI 1053845776

Jonathan R Ridenour, PAC

Practitioner Physician Assistant Montgomery, AL

Practice location

Address: 2105 E South Blvd, Montgomery, AL 36116-2409
Phone: (334) 288-2100
Mailing address: 8400 Country Club Way APT. L29, Knoxville, TN 37923-1844

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA.1244 (AL)

Other Physician Assistant providers in Alabama →

Registry record

NPI: 1053845776
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Apr 2017
Record last updated: 19 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.