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Contact Information

THADDEUS H RILEY, MD
23702 HWY 80 E
STATESBORO, GA30458
 Phone: 912-489-4090
 Fax: 912-765-5028
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for THADDEUS H RILEY · (Male)

NPI # 1104874031
Status Active
Credentials MD
Entity Individual
Enumeration date 05/04/2006
Last updated 10/27/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 028637
  • GA Medicaid 00351601C
Hospital affiliation(s)
  • EAST GEORGIA REGIONAL MEDICAL CENTER - (Acute Care)
    1499 FAIR ROAD
    STATESBORO, GA 30458
  • EFFINGHAM COUNTY HOSPITAL - (Critical Access)
    459 GA HIGHWAY 119 SOUTH
    SPRINGFIELD, GA 31329
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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