IndividualActive
Ryan Ellsworth, DPM
NPI 1104130574 · Foot Surgery Podiatrist · Atlanta, GA
Provider details
- NPI number
- 1104130574
- Entity type
- Individual
- Primary specialty
- Foot Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2109 (NV)
Practice location
505 Fairburn Rd Sw Ste 100
Atlanta, GA 30331-2012
Phone: (404) 618-6077
Fax: (801) 253-6888
Mailing address
9980 S 300 W Ste 300
Sandy, UT 84070-3654
Registry dates
- Enumerated
- 2010-07-28
- Last updated
- 2024-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.