Provider Demographics
NPI:1215919121
Name:RIDINGS-HESSER, SANDRA L (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:RIDINGS-HESSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:L
Other - Last Name:HESSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 10848
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-0848
Mailing Address - Country:US
Mailing Address - Phone:865-766-8800
Mailing Address - Fax:865-450-9374
Practice Address - Street 1:496 MEDLOCK RD LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1566
Practice Address - Country:US
Practice Address - Phone:404-687-8649
Practice Address - Fax:404-745-0907
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000392842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3326611Medicaid
TNE66229Medicare UPIN
TN3326612Medicare PIN
TN3326611Medicare PIN