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Contact Information

RYAN S ELLSWORTH, DPM
505 FAIRBURN RD SW STE 100
ATLANTA, GA30331-2012
 Phone: 404-618-6077
 Fax: 801-253-6888
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot

213ES0131X 48 Podiatry
 

Podiatrist

213E00000X 48 Podiatry
 

Primary Podiatric Medicine

213EP1101X 48 Podiatry
 

Radiology

213ER0200X 48 Podiatry
 

Sports Medicine

213ES0000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for RYAN S ELLSWORTH · (Male)

NPI Number 1104130574
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/28/2010
Last updated 06/17/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • CA License # E5797
  • FL License # PO4406
  • GA License # POD001473
  • NV License # 2109
  • UT License # 8400193-0501
  • UT Medicaid 1003111
  • CA Other E5797 CA DPM LICENSE
  • FL Other PO4406 FL DPM LICENSE
  • GA Other POD001473 GA DPM LICENSE
  • NV Other 2109 NV DPM LICENSE
  • UT Other 7672880001 DME
  • UT Other 8400193-0501 UT DPM LICENSE
Hospital affiliation(s) Not Available
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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