Basic Information
| Provider Information | |||||||||
| NPI: | 1174595904 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RING | ||||||||
| FirstName: | GUIDO | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 307 E 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | CORDELE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310153208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2292714656 | ||||||||
| FaxNumber: | 2292714654 | ||||||||
| Practice Location | |||||||||
| Address1: | 902 N 7TH ST | ||||||||
| Address2: | |||||||||
| City: | CORDELE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310153234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2292763100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 01/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 045325 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207R00000X | 045325 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00848504B | 01 | GA | DIALYSIS | OTHER | 000848504B | 05 | GA | MEDICAID | 00848504A | 05 | GA | MEDICAID |